Placenta previa is one of the leading causes of severe postpartum hemorrhage. When coinciding with placenta accreta, it may be associated with life-threatening maternal hemorrhage after removal of the placenta due to its incomplete separation and massive bleeding from the placental attachment site. Aim and Objective: To study the efficacy of conservative surgical techniques like Cho square compression sutures and Stepwise uterine devascularisation in controlling the bleeding from placental bed in cases of placenta previa. Material and Methods: This is a Prospective and Observational study carried out at Arundhathi Institute of Medical Sciences and Hospital over a period of 2 year. 90 pregnant women who were diagnosed to have placenta previa were taken into the study. Placenta previa diagnosed on USG undergoing abdominal delivery and who had placental bed bleed during surgery, irrespective of their gestational age and parity were included. Abruptio placenta and medical co-morbidities like pre-eclampsia, coagulation disorders were excluded. Estimated blood loss was assessed roughly by weighing of laparotomy pads before and after soiling and amount in suction apparatus. Results: The most common presentation of women with placenta previa is antepartum haemorrhage. 49 women (54.4%) presented with bleeding per vaginum at the time of admission and 41 (45.5%) presented with no complaints of bleeding per vaginum. Though placenta previa is more commonly seen in multi-gravidas, it is not so uncommon in primigravidas, with 14.4% of primigravidas in the study having placenta previa. The incidence of placenta previa was highest in women with third pregnancy accounting to 38 cases (42.2%), followed by second pregnancy (32 cases). Among 38 cases with third pregnancy, 21 cases (23.3 %) had 1 prior LSCS and 17 cases (18.8 %) had 2 prior LSCS. Conclusion: In order to decrease the morbidity rate and to prevent the adverse effects of hysterectomy, conservative surgical techniques like Cho Square compression sutures and Stepwise Uterine Devascularisation are effective in controlling placental bed bleed and can be considered as first step measures to control postpartum haemorrhage in cases of Placenta Previa. |