Transverse B-Lynch sutures for uterine preservation in patients with placenta accreta spectrum and placenta previa

Placenta accreta spectrum (PAS) involves abnormal trophoblastic invasion into the uterine myometrium, with increasing incidence due to rising cesarean section rates. PAS poses significant risks, including blood transfusion, bladder injury, intensive care unit admission, and hysterectomy. This study evaluates the use of transverse uterine compression sutures to provide localized compression in placenta previa and PAS cases.

We retrospectively analyzed medical records of 55 pregnant women diagnosed with placenta previa and PAS. Patients were divided into two groups: placenta accreta (28 women) and placenta increta (27 women). Demographic data, intraoperative, and postoperative outcomes were compared between the groups.

In the placenta accreta group, transverse sutures alone were sufficient in all cases. In the placenta increta group, four cases required a Bakri balloon, and two of those also needed uterine artery ligation for successful bleeding control. None of the patients required hysterectomy. Hemoglobin changes, mean arterial pressure, and fever were higher in the placenta increta group, but no statistically significant differences were observed in other parameters.

Transverse uterine compression sutures are highly effective in managing placenta previa and PAS. In severe cases like placenta increta, additional interventions may be necessary to control bleeding.