IMR Press / CEOG / Volume 50 / Issue 9 / DOI: 10.31083/j.ceog5009180
Open Access Original Research
Barbed Suture versus Conventional Suture for Uterine Repair in Women with Placenta Accreta and Placenta Increta: A Retrospective Cohort Study
Ruihong Dong1,2,3,†Lin Zhang1,2Qian Chen1,2Qiuhe Chen1,2Yuxia Wu1,2Dan Shan1,2,*,†Yayi Hu1,2,3,*,†
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1 Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
2 Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, 610041 Chengdu, Sichuan, China
3 Qingbaijiang Women’s and Children’s Hospital, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, China
*Correspondence: (Dan Shan); (Yayi Hu)
These authors contributed equally.
Clin. Exp. Obstet. Gynecol. 2023, 50(9), 180;
Submitted: 3 March 2023 | Revised: 30 April 2023 | Accepted: 22 May 2023 | Published: 30 August 2023
(This article belongs to the Special Issue Placenta Previa)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Placenta accreta spectrum can cause catastrophic hemorrhage. Knotless barbed suture line has been considered to reduce bleeding during cesarean section (CS). The purpose of this study was to determine whether the use of knotless barbed suture line could effectively reduce bleeding in patients with placenta accreta and placenta increta. Methods: After obtaining ethical approval, we performed a retrospective cohort study between women with the barbed suture (n = 42) and no barbed suture (control, n = 42). In the barbed suture group, the bleeding site from the damaged myometrium layer caused by the placenta villous invasion was sutured by barbed line with a continuous running suture made in the myometrium layer. In the control group, the uterine incision was repaired with two layers of a continuous suture using the conventional polyglactin suture line. Primary outcomes were the blood loss during the CS and blood loss in the first 24 hours after surgery. Results: The total sample size was 84 (42 in the barbed suture group, another 42 in the control group). Blood loss during CS was significantly lower than the control group by an average of approximately 200 mL (848.57 ± 373.20 mL in the barbed suture group vs. 1055.95 ± 470.88 mL in the control group, p = 0.028). Blood loss during the first 24 hours was also diminished in the barbed suture group (42.70 ± 36.71 mL in the barbed suture group vs. 65.60 ± 61.44 mL in the control group, p = 0.041). Conclusions: The application of barbed suture line reduced blood loss both during CS and after 24 hours of CS.

barbed suture
placenta accreta
placenta increta
postpartum hemorrhage
2022YFS0043/Sichuan Science and Technology Program
2023YFS0217/Sichuan Science and Technology Program
2019-YF05-00448-SN/Technological research and developmental innovation project of Chengdu
2020CDZG-23/Science and technology cooperation project of Sichuan University and Zigong
Fig. 1.
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