Rectangular-Shaped Hemostatic Sutures in the Management of Second-Trimester Placenta Accreta Spectrum Disorders at Tu...

The study aimed to delineate the surgical outcomes of rectangular-shaped sutures in PAS surgery.Materials and Methods This retrospective study was conducted between January 2018 and December 2022 at Tu Du Hospital in Vietnam. The study reviewed all PAS cases below 22 weeks of gestational age (GA) that underwent cesarean delivery with rectangular-shaped hemostatic sutures. All the pregnancy characteristics, surgical features, and postoperative outcomes were described.

Among thirteen pregnant women with PAS, GA from 13 to 17 weeks of GA occupied 11/13 cases. PAS was classified as accreta ( n  = 1), increta ( n  = 1), increta-percreta ( n  = 2), percreta ( n  = 4), and percreta invasive to other organs ( n  = 5). The estimated blood loss was 761.54 ± 614.12 (150-2,100 mL). Intraoperative blood loss between 500 and 1,500 mL accounted for 46.15%. The surgical duration time was 180.77 ± 32.07 (130-260 minutes). Postoperative duration time was 5.85 ± 2.08 (4-12 days). During the postpartum course, one case was reported with postpartum hemorrhage, acute renal dysfunction, and postoperative infection, respectively. Out of 13 PAS cases, 12 cases were successfully managed with conservative surgery.

Surgical management of PAS disorders using rectangular-shaped hemostatic sutures could be acceptable. The technical suture is simple, safe, and cost-effective.