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. 2024 Dec;167(3):1214-1221.
doi: 10.1002/ijgo.15796. Epub 2024 Jul 18.

Innovative hemostasis technique for cesarean section in placenta previa: A retrospective study

Kosuke Kawakami  1   2 , Yusuke Kurokawa  1   2 , Kohei Urago  1   2 , Yumika Maruyama  1 , Rie Fujikawa  1 , Hiroki Ishibashi  1 , Marie Kitagawa  1 , Takahiro Shimizu  1 , Tsugumichi Tokuda  1 , Hidehiro Kawagoe  1 , Mitsuru Muta  1 , Toshiyuki Yoshizato  2 , Naofumi Okura  1
Affiliations

Innovative hemostasis technique for cesarean section in placenta previa: A retrospective study

Kosuke Kawakami et al. Int J Gynaecol Obstet. 2024 Dec.

Abstract

Objective: To evaluate hemostatic efficacy, complications, and subsequent pregnancy outcomes in women with placenta previa who underwent combined vertical compression sutures in the lower uterine segment and intrauterine balloon tamponade (Hot-Dog method) to achieve hemostasis after cesarean section.

Methods: We retrospectively reviewed data for 117 women with singleton pregnancy diagnosed with placenta previa who underwent cesarean section between 29 and 38 weeks' gestation. Treatments were as follows: (1) conventional-intravenous oxytocin administration after placental detachment and suturing of bleeding points at the detachment site as needed (conventional group) (n = 47). (2) Intrauterine balloon tamponade alone (balloon group) (n = 41). (3) Vertical compression sutures + intrauterine balloon tamponade (Hot-Dog group) (n = 29).

Results: The placenta accreta spectrum prevalence was significantly higher in the balloon and Hot-Dog groups versus the conventional group. The prevalence of anteriorly located placenta was significantly higher in the Hot-Dog versus balloon groups. Intraoperative and total blood loss were significantly higher in the Hot-Dog versus conventional groups. Postoperative blood loss was significantly lower in the Hot-Dog versus balloon groups. Fewer additional procedures for managing postoperative hemorrhage were required in the Hot-Dog versus conventional and balloon groups. The number of subsequent pregnancies in the conventional, balloon, and Hot-Dog groups was 11 (23.4%), 8 (19.5%), and 4 (13.8%), respectively; all resulted in live births at term without serious obstetric complications.

Conclusion: The Hot-Dog method is a straightforward and safe hemostasis technique for placenta previa that preserves fertility and controls severe bleeding.

Keywords: cesarean section; hemostasis; intrauterine balloon tamponade; lower uterine segment; placenta accreta spectrum disorders; placenta previa; vertical compression suture.

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References

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