Suturing the placental bed in addition to intrauterine balloon tamponade, is it effective in placenta previa patients?

BACKGROUND

This study aimed to examine the effectiveness of placental bed sutures in placenta previa (PP) patients and compare the amount of estimated blood loss (EBL) in patients who were only applied intrauterine balloon tamponade (IUBT) with the patients who were applied suturing to the placental bed in addition to IUBT.

METHODS

PP patients (n:118) who were applied IUBT for postpartum hemorrhage (PPH) were the inclusion criteria. PP patients who were only applied IUBT constituted the suture-negative group (n:65) and the patients who were applied suturing to the placental bed in addition to IUBT constituted the suture-positive group (n:53). Clinicodemographic features, transfused blood and/or blood products, uterotonics used, EBL, and the volume IUBT inflated, and the duration of IUBT, were recorded and compared between the groups.

RESULTS

The median volume IUBT inflated was 200 (160-460) mL and the median duration of IUBT was 12 (6-24) hours in PP patients. The amount of EBL was shown to be higher in suture-positive group (p = 0.003). Multivariate logistic regression analysis revealed that presence of suturing the placental bed was associated with severe PPH (p = 0.017).

CONCLUSIONS

IUBT, is a successful method that is easily applicable, and administration of IUBT without suturing the placental bed may be sufficient to manage PPH in low-risk PP patients.