Uterine compression sutures for postpartum hemorrhage: an overview

Abstract

In 1997, B-Lynch pioneered the use of uterine compression sutures for postpartum hemorrhage. Since then, some researchers, including ourselves, have devised various uterine compression sutures. High-level evidence has not been demonstrated as to whether compression sutures achieve better and safer hemostasis for postpartum hemorrhage than other methods, and, if they do, whether one suture is more efficient and safer than another. However, generally speaking, uterine compression sutures have achieved hemostasis while preserving fertility in many women and thus their efficacy and safety have been timetested. Each suture has both merits and drawbacks: obstetricians must be aware of the fundamental characteristics of various sutures. In this review, we summarize the technical procedures, efficacy, safety and complications of various uterine compression sutures. We add our own experiences and opinions where necessary.

Evaluation of Patients with Postpartum Hemorrhage Patients in a University-Affiliated Tertiary Care Hospital

“…However, hemorrhage could not be stopped and relaparotomy was finalized with hysterectomy. Cekmez et al An average success rate of hemostasis by compression sutures has been reported to be 97% in an overview of 11 original articles (13) and 66% (14) and 75% (15) in other reported case series. We applied uterine compression sutures in two patients who underwent hysterectomy.…”

Uterine Compression Suture for Cesarean Hysterectomy: Possible Applications to Conditions other than Atonic Bleeding

“…Bi-manual compression, uterine massage, and administration of uterotonics did not achieve hemostasis. We performed relaparotomy and first performed MY uterine compression suture, in which two longitudinal and two transverse transfixing sutures were placed as previously described [2,3]. MY suture ameliorated uterine atony but severe bleeding from the lower uterine segment continued.…”

“…Since the introduction of B-lynch [1], various Uterine Compression Sutures (UCS) have been reported [2]. We also described a novel UCS, Matsubara-Yano (MY) suture [2,3].…”

“…We also described a novel UCS, Matsubara-Yano (MY) suture [2,3]. Thus, UCS have been widely acknowledged as a possible "second-line treatment of postpartum hemorrhage" [4].…”

“…We wish to describe other two applications; they are prophylaxis for acute re-inversion after repositioning of postpartum uterine inversion [2,3,[9][10][11][12], and prophylaxis of bleeding after perimortem cesarean section.…”