title: A modified suture technique for hemorrhage during cesarean delivery complicated by complete placenta previa.
abstract: OBJECTIVE
  To assess the usefulness of a modified suture to treat postpartum bleeding among patients with complete placenta previa (CPP).
  
  
  METHODS
  An observational study was conducted at Beijing Chaoyang Hospital, Beijing, China, among patients with CPP (with or without placenta accreta) who were enrolled from January 1 to March 31, 2014. During surgery, a Foley catheter balloon containing 60-120 mL of water was used to compress the hemorrhage site and an absorbable suture was placed around the lower uterus segment to provide extra pressure on the balloon.
  
  
  RESULTS
  Seven women with CPP underwent the procedure. The median hemostatic time was 4.6 minutes (range 3.0-7.0). The median estimated blood loss during surgery was 480 mL (range 400-600) for deliveries not complicated with placenta accreta and 1250 mL (range 1000-1500) for women with placenta accreta. Active bleeding was stopped after application of the modified suture; blood loss was less than 100mL in all cases in the 24 hours after surgery.
  
  
  CONCLUSIONS
  The modified suture technique provided an easy and efficient surgical choice for women with CPP, especially among those with placenta accreta.
authors.affiliation: Department of Gynecology and Obstetrics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Gynecology and Obstetrics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Gynecology and Obstetrics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Gynecology and Obstetrics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Gynecology and Obstetrics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Gynecology and Obstetrics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. Electronic address: lujunli200868@126.com.
authors.forename: Junli
authors.initials: J
authors.lastname: Lu
mesh_terms: D000328:Adult; D000068476:Beijing; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D010921:Placenta Accreta / Q000601:surgery*; D010923:Placenta Previa / Q000601:surgery*; D006473:Postpartum Hemorrhage / Q000601:surgery*; D011247:Pregnancy; D013536:Suture Techniques
keywords: Cesarean delivery; Complete placenta previa; Foley catheter; Lu suture; Placenta accreta; Postpartum hemorrhage