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

Abstract

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.

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

“…We would like to thank Professor Matsubara for his interest in our manuscript recently published in this journal. 1 We were honored to have an esteemed obstetrician like Professor Matsubara criticize our manuscript.…”

“…H-Hayman is a modified technique that can reduce the problems that may be encountered in the previously described Hayman technique. 1,2 The basic principle in all UCS techniques is to support involution by compressing the uterus in cases of postpartum hemorrhage due to atony, thus reducing postpartum hemorrhage mortality and morbidity, without the need for hysterectomy. Hayman compression suture is one of the easiest techniques to learn and apply among the defined UCS techniques.…”

“…2 The H-Hayman technique not only prevents slide-off of the sutures, as in Case 3 in the original Hayman report, but it also supports the fundal compression obtained when four vertical sutures are used, as in Case 2. 1,2 Since there is no further needle entry into the uterus, there may not be additional adverse effects. All these advantages make our technique unique.…”