Application of Uterine Artery Ligation,Uterine Artery Embolization and B-Lynch Suture in Patients with Pernicious Placenta Previa and Postpartum Hemorrhage

ZHANG Jingli; LIU Kan; WU Haiying

doi:10.3969/j.issn.1004-437X.2025.21.010

Abstract：Objective To explore the application of uterine artery ligation,uterine artery embolization and B-Lynch suture in patients with pernicious placenta previa complicated with postpartum hemorrhage.Methods Retrospective analysis was performed on 80 patients with pernicious placenta previa admitted to department of obstetrics and gynecology of Henan Provincial People's Hospital from January 2020 to July 2023.All patients were divided into ligation group(25 cases,uterine artery ligation treatment),embolization group(26 cases,uterine artery embolization treatment)and suture group(27 cases,B-Lynch suture treatment)according to the surgical methods.The successful hemostasis rate and hysterectomy rate,intraoperative indicators(surgical time,intraoperative blood loss volume and hospital stay),occurrence of complications,postoperative indicators(blood loss volume within 24 hours after surgery,blood transfusion volume within 24 hours,albumin within 24 hours),postoperative menstrual recovery time and uterine involution time were compared among the three groups of patients.Results There were no statistically differences in the successful hemostasis rate and hysterectomy rate among the three groups(P＞0.05).The surgical time in ligation group and suture group was longer than that in embolization group(P＜0.05),and the intraoperative blood loss volume in embolization group and suture group was less than that in ligation group(P＜0.05),but the hospital stay was not significantly different among the three groups(P＞0.05).There was no statistical significance in the total incidence rate of complications among the three groups(P＞0.05).The blood loss volume and blood transfusion volume in embolization group with 24 hours after surgery were less than those in ligation group and suture group(P＜0.05),while the albumin within 24 hours after surgery was higher than that in ligation group and suture group(P＜0.05).The difference in menstrual recovery time was not statistically significant among the three groups(P＞0.05),but the uterine involution time was shorter in embolization group than that in ligation group and suture group(P＜0.05),and the uterine involution time in suture group was significantly lower than that in ligation group(P＜0.05).Conclusion Uterine artery ligation,uterine artery embolization and B-Lynch suture can effectively improve the pernicious placenta previa with postpartum hemorrhage and reduce the risk of hysterectomy,and they are safe and effective.However,uterine artery embolization is relatively simpler and has shorter surgical time and fastest postoperative uterine involution.