Efficacy of Sandwich Technique (Balloon Tamponade and Compression Suture) in Cases of Placenta Previa and Accreta

Memoona Rehman; Saba Khan; Saira Nazeer; Erum Majid; Khadija Bano

doi:10.71104/jsogp.v14i4.866

Memoona Rehman Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Center, Karachi
Saba Khan Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Center, Karachi
Saira Nazeer Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Center, Karachi
Erum Majid Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Center, Karachi
Khadija Bano Department of Obstetrics and Gynecology, Al Tibri Medical College, Isra University, Karachi

DOI: https://doi.org/10.71104/jsogp.v14i4.866

Keywords: Placenta Previa, Postpartum hemorrhage

Abstract

Objective: To assess Sandwich Balloon Technique (SBT) efficacy in cases of Placenta Previa (PP) and Placenta Accreta (PA) as uterine conserving hemostatic method in Caesarean Sections.

Methodology: This quasi experimental study was carried out in cases of PP and PA employing SBT (compression suture + balloon tamponade) as a uterine conserving method, in a tertiary care hospital of Karachi from 1^stJuly 2022 till 31^st December 2022. Outcome measures including blood loss during surgery, intra-operative blood transfusions, post-operative complications, balloon tamponade removal time, post-operative hospital stay and hysterectomy were recorded. Descriptive statistics were analyzed by means of SPSS 22.

Results: Out of 50 patients, 34(68%) had PP and 16(32%) PA. Mean blood loss 972±474ml; mean blood transfusion1.8±1.37units, balloon tamponade removal time in 24 hours 52% and in 48 hours 38%, average hospital stay 3.44±1.64 days, failure resulting in hysterectomy in five patients (10%) and complications including fever, haemorrhage, wound infection and bladder injury in 11 (22%) patients. There was no case of delayed hemorrhage, significant maternal morbidity or mortality. SBT was 100% effective in controlling hemorrhage in cases of PP and 68.8% in cases of PA.

Conclusion: SBT is a safe, feasible, effective hemorrhage controlling method for PP and PA cases and is extremely beneficial uterine conserving technique.