Abstract:

Objective To analyze the pregnancy outcomes of combined B-Lynch suture and intrauterine packing with gauze versus combined B-Lynch suture and intrauterine balloon tamponade in the treatment of central placenta previa with abnormally adherent placenta. Methods A retrospective analysis was conducted on 48 patients with central type placenta previa combined with adhesive placental implantation at Nanfang Hospital of Southern Medical University from July 2021 to October 2023. Among them， 23 patients were treated with B-Lynch suture combined with uterine gauze tamponade （study group）， and 25 patients were treated with B-Lynch suture combined with uterine balloon tamponade （control group）. The intraoperative bleeding volume， postpartum 24-hour bleeding volume， postoperative intervention surgery rate， postoperative ICU transfer rate， and hospitalization costs were compared between the two groups. Results There was no statistically significant difference in intraoperative bleeding between the two groups （P > 0.05）. Compared with the control group， the study group showed a decrease in 24-hour postpartum hemorrhage， red blood cell infusion， surgical time， and hospitalization costs； The postoperative hospitalization days are shorter （P < 0.05）. Three patients in the control group underwent uterine artery embolization intervention surgery， and one patient was transferred to the ICU. There was no statistically significant difference in the ICU transfer rate and postoperative intervention surgery rate between the two groups （P > 0.05）. There was no difference in Apgar scores between the two groups of newborns. After discharge， patients were followed up until 42 days postpartum， and the results showed that all patients had no late postpartum hemorrhage， no poor healing of uterine incisions， no complications such as bladder ureteral injury and intestinal obstruction. Conclusion Combined B-Lynch suture and intrauterine gauze packing is a simple， feasible， safe， and reliable hemostatic method. It is suitable for primary healthcare institutions and worthy of promotion.

Key words: placenta previa, abnormally adherent placenta, postpartum hemorrhage B-Lynch sutures, intrauterine gauze packing, intrauterine balloon tamponade