title: Symbol "&" suture to control atonic postpartum hemorrhage with placenta previa accreta.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of a symbol "&" compression suture technique in controlling severe atonic postpartum hemorrhage with placenta previa accreta during cesarean delivery.
  
  
  METHODS
  Nine women with heavy postpartum bleeding from uterine inertia and placenta previa percret, which did not react to conventional initial management protocols, were underwent the suture in the shape of symbol "&" in China Meitan General Hospital. The suture procedure was to staple the anterior and posterior walls (of the lower uterine segment as well as corpus uterus) together using number 1 chromic catgut, with a cross at about 2 cm above the upper boundary of lower uterine segment.
  
  
  RESULTS
  Symbol "&" compression suture was capable of stanching the postpartum hemorrhage immediately in all nine women. None of these patients developed complications related to this method. Subsequent pregnancies after the suture were occurred in two women and delivered with repeat cesarean section.
  
  
  CONCLUSIONS
  Symbol "&" compression suture is a simple, safe and highly effective technique to control the treatment-resistant uterine atonic bleeding, particularly in previous cesarean scar at lower segment and placenta previa accreta.
authors.affiliation: Department of Obstetrics and Gynecology, China Meitan General Hospital, No.29 Xibahe Nanli, Chaoyang District, Beijing, 100028, People's Republic of China.
authors.forename: Guang Tai
authors.initials: GT
authors.lastname: Li
authors.forename: Xiao Fan
authors.initials: XF
authors.lastname: Li
authors.forename: Ya Jing
authors.initials: YJ
authors.lastname: Liu
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Hong Mei
authors.initials: HM
authors.lastname: Xu
mesh_terms: D000328:Adult; D002585:Cesarean Section; D017604:Cesarean Section, Repeat; D002681:China; D002921:Cicatrix / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010921:Placenta Accreta / Q000601:surgery*; D010923:Placenta Previa / Q000601:surgery*; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000601:surgery*; D011247:Pregnancy; D011312:Pressure; D017792:Surgical Stapling; D013536:Suture Techniques; D013537:Sutures; D014593:Uterine Inertia / Q000601:surgery*; D014599:Uterus / Q000601:surgery; D055815:Young Adult