Application of uterine suture under tourniquet binding in placenta previa patients with severe placenta implantation

Abstract Objective To investigate the clinical feasibility and safety of uterine suture use under rubber tourniquet binding in placenta previa patients with severe placenta implantation. Methods A retrospective analysis of 60 pregnant women with placenta previa and severe placenta implantation who underwent cesarean section from June 2018 to June 2023 was conducted. The different methods used to block blood vessels can be divided into two groups. Among them, 30 cases of uterine sutures assisted by interventional blocking of uterine blood vessels were used as the interventional group, and 30 cases of uterine sutures assisted by rubber tourniquets binding whole pelvic blood vessels were used as the tourniquet group. Results There were no significant differences in clinical characteristics between the intervention group and the tourniquet group (P > 0.05). The operation time was 180.68 ± 66.61 minutes in the interventional group and 118.32 ± 38.23 minutes in the tourniquet group. The difference between the two groups was significant (p < 0.01). The median 24-hour postpartum hemorrhages were 1990.32 (1000, 2500) and 1574.19 (900, 2000) (p = 0.172), respectively. The postoperative hospital stays were 7.58 ± 2.20 and 5.87 ± 1.69 (p = 0.01). The hospitalization expenses were M (P25, P75) 44037.10 (34331.84,52373.1) and 20480.69 (15389.04,22913.65) (p < 0.01); among them, the costs of blood transfusion were 5778.79 (1641.00,9918.71) and 2825.97 (1244.98,3760.00) (p < 0.01); and the short-term complication rates (n, %) were 11 (36.67%) and 2 (6.45%) (p < 0.05). The two groups were compared in terms of operation time, postoperative hospitalization days, hospitalization expenses and short-term complications, and the differences were statistically significant (p  0.05). Postoperative 1-year follow-up,the comparison of the two groups of surgical long-term complications (n,%) was 10 (33.33%) and 8 ( 26.67%) (p = 0.399), The difference was not statistically significant. Conclusion In the surgical treatment of placenta previa complicated with severe placenta accreta, uterine suturing under tourniquet binding can quickly and effectively control massive intraoperative bleeding, shorten the operation time, and reduce postoperative hospitalization days, hospitalization expenses and blood transfusion costs. This surgical method is more accessible than interventional surgery. It is easy to perform, simple and has good hemostatic effects. It is a safe and effective surgical treatment method.