title: Use of early transverse annular compression sutures for complete placenta previa during cesarean delivery.
abstract: OBJECTIVE
  To compare the difference in maternal outcomes between early and late use of transverse annular compression sutures (TACS) during cesarean delivery among women with complete placenta previa (CPP).
  
  
  METHODS
  A retrospective study of 36 women with CPP was conducted. Percentiles of blood loss before TACS were calculated. The transfusion rate, sensitivity, specificity, Youden index, positive predictive value, and negative predictive value were also estimated. Patients were assigned to either the early TACS group or the late TACS group based on the highest Youden index. Maternal outcomes of the 2 groups were compared.
  
  
  RESULTS
  The Youden index for transfusion rate was highest when blood loss before TACS reached 500 mL. Blood loss before intervention in the late TACS group was significantly higher than in the early TACS group (735.0 ± 123.7 mL versus 396.9 ± 76.3 mL; P<0.001). More women in the late TACS group than in the early TACS group required blood transfusion (60.0% versus 12.5%; P=0.004) and the volume of blood transfused was significantly lower in the early TACS group than in the late TACS group (137.5 ± 377.5 mL versus 806.7 ± 619.3 mL; P=0.001).
  
  
  CONCLUSIONS
  Early implementation of TACS could lead to improved maternal outcomes.
authors.affiliation: Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Yi-Ying
authors.initials: YY
authors.lastname: Huang
authors.forename: Jing-Yi
authors.initials: JY
authors.lastname: Zhuang
authors.forename: Yi-Rong
authors.initials: YR
authors.lastname: Bao
authors.forename: Hao
authors.initials: H
authors.lastname: Ying
authors.forename: De-Fen
authors.initials: DF
authors.lastname: Wang
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion / Q000379:methods; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D010923:Placenta Previa / Q000601:surgery*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult