Evaluation of “J”-shaped uterine incision during caesarean section in patients with placenta previa: A retrospective study

Abstract

This study evaluated the efficacy and safety of "J"-shaped uterine incision for caesarean section for patients diagnosed with placenta previa. A total of 55 consecutive cases of placenta previa treated in Union Hospital were retrospectively analyzed over a period of two years and 10 months. The subjects were divided into two groups with respect to the uterine incision. Twenty-four pregnant women with placenta previa who were indicated for caesarean section underwent the procedure using a new "J"-shaped uterine incision and 31 pregnant women with placenta previa received caesarean section that used the traditional transverse incision. The two groups were compared in terms of operation time, estimated blood loss, infant expulsion time, exhaust time and postoperative recovery. Meanwhile, comparison was also made in neonatal clinical data between the two groups. Compared with the "J"-shaped incision group, the traditional incision group had a lower Apgar scores (P<0.05). However, there existed no statistically significant differences in the overall time of operation and postoperative period of breaking wind (P>0.05). It is concluded that, with caesarean section for placenta previa patients, the "J"-shaped uterine incision significantly decreases intraoperative blood loss and facilitates the fetal delivery.

Placenta Praevia and Placenta Accreta: Diagnosis and Management

“…95 A 'J'-shaped uterine incision has been evaluated in women presenting with placenta praevia in a small retrospective study and shown to decrease intraoperative blood loss and facilitate the delivery of the fetus. 96 Evidence level 2À…”

Complete cervical inversion and nearly inappropriate stitching with cesarean section during the second stage of labor: a case report

“… 10 , 11 The traction method has the advantages of less possibility of laceration of the uterine incision, less bleeding during the operation, a shorter operative time and hospital stay, and a lower incidence of puerperal diseases compared with the method of removing the head through the vagina. 12 Because the fetal head is deep in the pelvis in the second stage of labor, which significantly increases the difficulty of reaching the lowest point of the fetal head by hand, when the head is held, the uterine incision may tear on both sides and below. In particular, laceration of the incision and massive bleeding prolong the operation time.…”

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“…A retrospective cohort study found that avoiding incision of the anterior placenta praevia after 24 weeks of gestation reduces the need for maternal blood transfusion during or after caesarean delivery [95]. A 'J'-shaped uterine incision has been evaluated in women presenting with placenta praevia in a small retrospective study and shown to decrease intraoperative blood loss and facilitate the delivery of the fetus [96].…”