Hemostatic compression treatment of central placenta previa with modified Cho suture

Placenta previa (PP) occurs when the placental edge lies within 2 cm of the internal cervical orifice and increases the risk of placenta accreta, especially in women with prior cesarean delivery, uterine surgery, or advanced maternal age. Patients with central PP typically undergo elective cesarean section. Hemorrhagic complications are common even in the absence of accreta. We present the case of a 46-year-old woman who conceived through in vitro fertilization and with an uneventful pregnancy. A third-trimester ultrasound confirmed central PP. An elective cesarean section was scheduled at 38 weeks. Manual removal of the placenta was difficult, and bleeding from the placental bed persisted. Due to the midline location of the bleeding vessels, modified Cho compression sutures were applied solely to the posterior uterine wall using resorbable monofilament, achieving effective hemostasis. This case highlights that modified compression sutures can be adapted to control hemorrhage effectively, reducing the need for more invasive interventions.