Efficacy of King's Combined Uterine Suture in Managing Placenta Accreta: A Retrospective Analysis.

Abstract

BACKGROUND Placenta accreta is a spectrum disorder that can include an abnormally adherent placenta to placental tissue that invades the endometrium and myometrium and results in hemorrhage during or after delivery. King's combined uterine suture is a combination of parauterine vascular ligation with longitudinal suturing of the lower uterine segment. This retrospective study aimed to evaluate outcomes from using King's combined uterine suture for hemostasis in 49 parturient women with placenta accreta spectrum (PAS). MATERIAL AND METHODS Clinical data of parturient women with placenta accreta in Fujian Maternal and Child Health Hospital from January 2020 to January 2023 were retrospectively collected. King's combined uterine suture ligation surgery was performed in these patients who had placenta accreta. Placenta accreta was diagnosed by the criteria for PAS. The outcomes of surgery and prognosis of newborns were analyzed. RESULTS A total of 49 parturient women were included and underwent successful intraoperative hemostasis without hysterectomy or ureteral injury. There were 4 cases of bladder rupture and 17 cases of uterine plastic surgery. The average intraoperative bleeding volume of the 49 patients was (507±162) mL. Patients had no long-term complications during postoperative follow-up. Apgar score of newborns was 9.67±0.77, and there was no asphyxia or neonatal death. CONCLUSIONS King's combined uterine suture ligation surgery is applied to placenta accreta, which not only has a definite and fast hemostatic effect, but can also effectively preserve the uterus.