A novel technique in the management of severe postpartum uterine atony bleeding: Three vertical uterine compression sutures

Özdemir, İsmail; Özdemir, Özge; Özköse, Zeynep Gedik

doi:10.1016/j.ejogrb.2021.03.038

Cited by 8 publications

(7 citation statements)

References 7 publications

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“…Fourth, the sutures in the fundal region may shift to the side, the ballooning part between the fundal sutures may continue to bleed, and the uterus may bend anteriorly from the fundal part during the tightening of the sutures if the assistant is inexperienced. Finally, this technique is more difficult to learn for an obstetrician who does not have sufficient experience 7,11,12,18 . Given these disadvantages, we consider that the H‐Hayman method, a modified version of the Hayman technique, is easier to learn and faster, and simpler to apply and can be a good alternative to conventional UCS techniques.…”

Section: Discussionmentioning

confidence: 99%

“…uterine necrosis, pelvic pain, synechiae, pyometra, abdominal adhesions, and uterine rupture in later pregnancies) 8 . In addition, although vertical compression sutures, such as B‐Lynch and Hayman, compress the lateral edges of the uterus, the central ballooning portion may continue to bleed; also, the sutures may slide off the uterine fundus 7,11,12 …”

Section: Introductionmentioning

confidence: 99%

“…8 In addition, although vertical compression sutures, such as B-Lynch and Hayman, compress the lateral edges of the uterus, the central ballooning portion may continue to bleed; also, the sutures may slide off the uterine fundus. 7,11,12 With the H-Hayman technique described in this paper, some risks of vertical UCS techniques can be reduced. We compared 14 cases in which we applied this modified technique, described here for the first time in the literature, with 21 cases that underwent suturing with conventional vertical UCS techniques.…”

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confidence: 99%

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Comparison of H‐Hayman uterine compression suture with conventional vertical sutures: A cross‐sectional study in a tertiary center

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Farisoğulları

Sakcak

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo compare H‐Hayman, a modified uterine compression suturing technique (UCS) that we describe for the first time in the literature, with conventional vertical UCS techniques.MethodsThe H‐Hayman technique was used in 14 women and the conventional UCS technique in 21 women. In order to provide standardization in the study, only patients who had developed upper‐segment atony during cesarean section were recruited for the study.ResultsBleeding control was achieved in 85.7% (12/14) of the cases using the H‐Hayman technique. In the remaining two patients with persistent hemorrhage in this group, bleeding control was provided with bilateral uterine artery ligation, and a hysterectomy was avoided in all cases. With the conventional technique, bleeding control was achieved in 76.1% (16/21) of the patients, and the overall success rate was 95.2% after bilateral uterine artery ligation in those with persistent hemorrhage. In addition, the estimated blood loss and the need for erythrocyte suspension transfusion were significantly lower in the H‐Hayman group (P = 0.01 and P = 0.04, respectively).ConclusionWe found the H‐Hayman technique to be at least as successful as conventional UCS. In addition, patients who underwent suturing with the H‐Hayman technique had less blood loss and a lower requirement for erythrocyte suspension transfusion.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison of H‐Hayman uterine compression suture with conventional vertical sutures: A cross‐sectional study in a tertiary center

Denızlı

Farisoğulları

Sakcak

et al. 2023

Intl J Gynecology & Obste

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“…In cases of failed pharmacologic management, mechanical and surgical intervention offers an attempt to treat uterine atony. Several uncontrolled case series on surgical techniques have been published in recent years that offer various techniques using compression sutures, balloon tamponade, and vacuum systems [24–27,28 ▪ ,29,30 ▪▪ ]. Although these techniques offer alternatives to pharmacologic therapy, the studies did not use randomized design, so their efficacy should be interpreted with caution.…”

Section: Mechanical and Surgical Approaches To Treating Uterine Atonymentioning

confidence: 99%

“…Vertical compression sutures, similar to the Hayman technique which is classically described after vaginal delivery (without a hysterotomy), includes bilateral sutures placed 2 cm from the lateral edge of the uterus and 4 cm from the cornual border, and a third placed in the midline at the same level [27].…”

Section: Mechanical and Surgical Approaches To Treating Uterine Atonymentioning

confidence: 99%

Uterine atony

Miller

Ansari

2022

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewPostpartum hemorrhage (PPH) is the leading preventable cause of maternal morbidity and mortality worldwide. Uterine atony is identified as the underlying etiology in up to 80% of PPH. This serves as a contemporary review of the epidemiology, risk factors, pathophysiology, and treatment of uterine atony.Recent findingsRates of postpartum hemorrhage continue to rise worldwide with the largest fraction attributed to uterine atony. A simple 0–10 numerical rating score for uterine tone was recently validated for use during cesarean delivery and may allow for more standardized assessment in clinical and research settings. The optimal prophylactic dose of oxytocin differs depending on the patient population, but less than 5 units and as low as a fraction of one unit is needed for PPH prevention, with an increased requirements within that range for cesarean birth, those on magnesium, and advanced maternal age. Carbetocin is an appropriate alternative to oxytocin. Misoprostol shows limited to no efficacy for uterine atony in recent studies. Several uncontrolled case studies demonstrate novel mechanical and surgical interventions for treating uterine atony.SummaryThere is a critical, unmet need for contemporary, controlled studies to address the increasing threat of atonic PPH.

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