TITLE:
A Different Method in the Treatment of Placenta Previa: A Comparison of Lower Uterine Segment Transverse Suture Technique and Bakri Balloon Application
AUTHORS:
Gamze Savcı, Ayse Z. Ozdemir, Pervin Karlı, İdris Kocak, Yunus Katırcı, Mesut Önal
KEYWORDS:
Placenta Previa Totalis, Bakri Balloon, Hysterectomy, Compression Suture
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.3,
March
8,
2019
ABSTRACT: 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.