Efficacy of surgical techniques to control obstetric hemorrhage: analysis of 539 cases

Abstract

Bilateral occlusions of the uterine artery or its branches were useful procedures to stop upper uterine bleeding. Square sutures were a simple and effective procedure to control lower genital tract bleeding.

Uterine compression sutures for management of severe postpartum haemorrhage: a 5-year audit

“…23 In the literature, some series have described compression sutures solely used for placenta praevia/accreta, 11,14,18,24 while others detailed their use exclusively for atonic uteruses, 19,20 and still others referred to application of the technique to all aetiologies. 4,21 Apart from compressing the uterine body in uterine atony, the original paper on the B-Lynch suture also advocated its use for placenta praevia. It was proposed that the sutures would exert longitudinal compression and achieve evenly distributed tension over the uterus, including the lower segment.…”

“…19 Another interesting case series consisted of a single surgeon's experience in Argentina over a 20-year period, and involved 539 cases of excessive obstetric bleeding from a variety of causes, including uterine atony, placenta praevia/accreta, cervical scar pregnancies as well as uterine/vaginal/cervical tears. 21 Various surgical methods (often in combination) were utilised to treat these cases, and the overall success rate in those having the B-Lynch suture was 94% (81/86), while for Hayman sutures, Cho sutures, and Pereira sutures, the rates were 92% (34/37), 100% (37/37), and 100% (11/11), respectively. 21 The very high success rates reported in this personal series could be ascribed to excellent surgical skills, optimal patient selection, and choice of procedures by a super-specialist, but may be difficult to reproduce elsewhere.…”

“…21 Various surgical methods (often in combination) were utilised to treat these cases, and the overall success rate in those having the B-Lynch suture was 94% (81/86), while for Hayman sutures, Cho sutures, and Pereira sutures, the rates were 92% (34/37), 100% (37/37), and 100% (11/11), respectively. 21 The very high success rates reported in this personal series could be ascribed to excellent surgical skills, optimal patient selection, and choice of procedures by a super-specialist, but may be difficult to reproduce elsewhere.…”

Vertical compression sutures for control of postpartum hemorrhage from a placenta previa in cesarean section — To evaluate the usefulness of this technique

“…As has recently been reported, combining these hemostatic techniques may further improve their effectiveness in stopping hemorrhage. 19,20) In the present study, the introduction of VCS reduced intraoperative blood loss and the rate of patients suffering massive hemorrhage > 2,000 ml; VCS were performed in 14 cases and were effective in 14 cases (100%), suggesting that VCS may be a highly effective hemostatic procedure. The volume of hemorrhage exceeded 2,000 ml in 50% of patients who underwent VCS.…”

Perioperative Internal Iliac Artery Balloon Occlusion in Patients with Abnormal Placental Invasion

“…However, the recommended management of suspected abnormal placental invasion is planned preterm cesarean hysterectomy with the placenta left in situ, because removal of the placenta is associated with significant bleeding [5]. For the management of those high-risk patients, there are several surgical hemostatic techniques [11]. Prophylactic perioperative internal iliac artery balloon occlusion in cases of abnormal placental invasion was first reported in 1997 [12].…”