Efficacy of intraoperative wireless ultrasonography for uterine incision among patients with adherence findings in placenta previa

Abstract

Aim: We evaluated the effectiveness of intraoperative wireless ultrasonography in determining the location of uterine incision during cesarean delivery in patients with placenta previa who have sonographic adherence findings in order to assess intraoperative blood loss and maternal morbidity. Methods: A prospective study using wireless sonography, including 15 patients with previa, was conducted among women with singleton pregnancies who delivered by cesarean section between August 1, 2017, and August 30, 2019. Retrospective study for the control group included 32 patients with placenta previa who underwent cesarean section between January 1, 2016, and July 31, 2017, without wireless sonography. Patients with previa who had adherence findings in prenatal sonography were included in both groups. Logistic regression was used to identify the association between massive intraoperative bleeding loss and use of wireless ultrasound sonography. Results: Intraoperative blood loss was significantly reduced in the study group compared to that in the control group (P = 0.009). The hospital stay was significantly shorter in the study group compared to the control group (5 days vs 6 days, P < 0.001). The use of intraoperative wireless sonography (P = 0.01) had a significant association with massive intraoperative hemorrhage in multivariable analysis. Conclusion: Our study is the first study to apply a wireless ultrasound sonography device in women with placenta previa during cesarean section to examine maternal morbidity. This latest wireless ultrasound sonography device is advantageous for uterine incision guidance in women with placenta previa and improves maternal morbidity by reducing intraoperative hemorrhage. © 2020 Japan Society of Obstetrics and Gynecology