Application of lower uterine segment lifting suture combined with bilateral uterine wall reinforcement suture in the treatment of dangerous placenta praevia during Caesarean section
Objective To investigate the efficiency of lower segment of uterus lifting suture combined with bilateral wall rein-forcement suture in cesarean section of dangerous placenta praevia.Methods 11 patients with dangerous placenta praevia treated with lower uterine cervical lifting suture combined with bilateral uterine wall reinforcement suture were selected.The general con-dition,perioperative indicators,postoperative condition,and neonatal outcome were observed to evaluate the surgical effect.Re-sults Eleven cases were confirmed with placental implantation during the operation,with placenta invading the perimetrium in five cases.All the 11 patients underwent cervical lifting and suturing of the lower segment of the uterus combined during cesarean delivery,and there was no failure.The median amount of blood loss was 400(300-700)mL during the operation.The mean op-eration time was(65±14)minutes.Ten cases had normal lochia and temperature after the operation,without obvious signs of infection.The postoperative hospitalization time was ≤7 days.One patient developed fever of unknown cause after the operation,with normal lochia,blood routine and infection indicators.A follow-up gynecological ultrasound showed a small amount of fluid accumulation in the uterine cavity and no obvious placental tissue.They were automatically discharged 8 days after the operation.The follow-up after discharge showed no postpartum infection,and 11 cases showed no asphyxia in newborns.Five premature in-fants were cured and discharged without tracheal intubation to assist respiration after they were transferred to the neonatal depart-ment.Conclusion The lifting suture of the lower uterine cervix combined with the reinforcement suture of the bilateral uterine wall is highly effective and feasible for the operation of pernicious placenta previa.There is no obvious postpartum bleeding and strong postoperative complications during and after the operation.
cervical lifting and suturing of the lower segment of the uterusbilateral uterine wall reinforcement suturepla-centa previaplacenta accretathin lower segment of uterus
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