Objective: The incidence of placenta previa (PP) has been increasing due to the rise in cesarean rates. The aim of this study is to determine the success of lower uterine segment compression suture and bakri balloon a...Objective: The incidence of placenta previa (PP) has been increasing due to the rise in cesarean rates. The aim of this study is to determine the success of lower uterine segment compression suture and bakri balloon applications in patients diagnosed with placenta previa. Materials and Methods: 257 patients who underwent cesarean section due to placenta previa totalis (PPT) between the years of 2010-2018 in Ondokuz Mayis University were screened retrospectively. The patients were evaluated in four groups according to their treatment method: medical treatment, bakri balloon application, compression suture and hysterectomy. Results: In the study, between the years 2010-2015, postpartum hysterectomy was performed in the cases of adherent placenta previa, and hysterectomy was performed in 33 patients. Between the years of 2015-2018, first, bakri balloon or compression suture was applied;and if bleeding control was not achieved despite these, then, hysterectomy was performed. Between 2015 and 2018, a total of 27 patients underwent compression suture and 1 patient had a hysterectomy after all. The success rate was 96.3% with compression suture and 91.7% for bakri balloon application. Totally, 24 patients were treated with bakri balloon and yet, two patients underwent hysterectomy. When all the cases were examined, complications caused by urinary bladder and ureteral injury were seen in 5.6% of patients, and all of these complications were also seen in hysterectomy patients. Conclusion: Lower uterine segment transverse suture technique and bakri balloon application should be considered as a good alternative to prevent hysterectomy in patients with placenta previa totalis. In addition, they are effective treatment methods that can be used without increasing maternal morbidity.展开更多
文摘Objective: The incidence of placenta previa (PP) has been increasing due to the rise in cesarean rates. The aim of this study is to determine the success of lower uterine segment compression suture and bakri balloon applications in patients diagnosed with placenta previa. Materials and Methods: 257 patients who underwent cesarean section due to placenta previa totalis (PPT) between the years of 2010-2018 in Ondokuz Mayis University were screened retrospectively. The patients were evaluated in four groups according to their treatment method: medical treatment, bakri balloon application, compression suture and hysterectomy. Results: In the study, between the years 2010-2015, postpartum hysterectomy was performed in the cases of adherent placenta previa, and hysterectomy was performed in 33 patients. Between the years of 2015-2018, first, bakri balloon or compression suture was applied;and if bleeding control was not achieved despite these, then, hysterectomy was performed. Between 2015 and 2018, a total of 27 patients underwent compression suture and 1 patient had a hysterectomy after all. The success rate was 96.3% with compression suture and 91.7% for bakri balloon application. Totally, 24 patients were treated with bakri balloon and yet, two patients underwent hysterectomy. When all the cases were examined, complications caused by urinary bladder and ureteral injury were seen in 5.6% of patients, and all of these complications were also seen in hysterectomy patients. Conclusion: Lower uterine segment transverse suture technique and bakri balloon application should be considered as a good alternative to prevent hysterectomy in patients with placenta previa totalis. In addition, they are effective treatment methods that can be used without increasing maternal morbidity.
