Circular isthmic-cervical sutures can be an alternative method to control peripartum haemorrhage during caesarean section for placenta praevia accreta

Objective To study the control of peripartum bleeding in cases of caesarean section for placenta praevia accreta with the Circular isthmic-cervical sutures. Method Circular isthmic-cervical sutures were applied in six cases. To avoid ureter and bladder injury, the bladder was reflected downward. A silastic drain was inserted into internal and through the external os, so as to drain the uterine cavity and to keep the cervical canal open. Firstly, at the left side of the uterus, a Vicryl number two (No. 2) stitch was inserted very close to the cervix from the anterior to the posterior side of the broad ligament. The stitch was then passed posteriorly to the right side of the uterus. The needle then was inserted again very close to the cervix from the posterior to the anterior wall of the broad ligament and was tightened on the anterior uterine surface, above the reflexion of the bladder as tightly as possible. Result Circular isthmic-cervical sutures were effective in all cases. Conclusion Circular isthmic-cervical suture is a quick, safe, simple and effective technique for controlling peripartum haemorrhage during caesarean section for placenta praevia accreta.