Efficacy of Sandwich Technique (Balloon Tamponade and Compression Suture) in Cases of Placenta Previa and Accreta

Objective: To assess Sandwich Balloon Technique (SBT) efficacy in cases of Placenta Previa (PP) and Placenta Accreta (PA) as uterine conserving hemostatic method in Caesarean Sections. Methodology: This quasi experimental study was carried out in cases of PP and PA employing SBT (compression suture + balloon tamponade) as a uterine conserving method, in a tertiary care hospital of Karachi from 1st July 2022 till 31st December 2022. Outcome measures including blood loss during surgery, intra-operative blood transfusions, post-operative complications, balloon tamponade removal time, post-operative hospital stay and hysterectomy were recorded. Descriptive statistics were analyzed by means of SPSS 22. Results: Out of 50 patients, 34(68%) had PP and 16(32%) PA. Mean blood loss 972±474ml; mean blood transfusion1.8±1.37units, balloon tamponade removal time in 24 hours 52% and in 48 hours 38%, average hospital stay 3.44±1.64 days, failure resulting in hysterectomy in five patients (10%) and complications including fever, haemorrhage, wound infection and bladder injury in 11 (22%) patients. There was no case of delayed hemorrhage, significant maternal morbidity or mortality. SBT was 100% effective in controlling hemorrhage in cases of PP and 68.8% in cases of PA. Conclusion: SBT is a safe, feasible, effective hemorrhage controlling method for PP and PA cases and is extremely beneficial uterine conserving technique.