Uterine compression sutures: surgical management of postpartum hemorrhage

Abstract

Compression sutures placed into the postpartum uterus may provide a simple first surgical step to control bleeding when routine oxytocic measures have failed. We suggest that the technique we have described is a simple procedure and should be tried before more complex interventions are used.

Uterine Compression Suture; New Technique Using Parenchymal Set Suture

“…The chance of success is high and the procedure can be performed by surgeons with average surgical skills at units with limited resources. Since B-Lynch suture introduced, various other techniques had been described, such as Hayman suture [2] and Cho suture [3]. The technique being outlined in this report is following B-Lynch steps (although initially described using catgut suture material), but we proposed the parenchymal set suture can also be used in performing Hayman suture (90cm length).…”

Postpartum Hemorrhage after Cesarean Delivery - Causes and Management Statistics of „Prof. Dr. Panait Sîrbu „ Hospital- Bucharest

“…Hematological rebalancing was made by administering fresh blood, FFP, platelet mass, cryoprecipitate, antifibrinolytic (6 cases). Preservation of the uterus was obtained in only 15 cases (15.95 %); in all of them uterine artery ligation was performed [10]. Continuous vertical compression over the uterine vessels was done by B-Lynch compression suture [3,10,11] where there was abundant bleeding during caesarean section, after exhausting other conservative methods before the decision for hemostatic hysterectomy in 8 cases.…”

“…Preservation of the uterus was obtained in only 15 cases (15.95 %); in all of them uterine artery ligation was performed [10]. Continuous vertical compression over the uterine vessels was done by B-Lynch compression suture [3,10,11] where there was abundant bleeding during caesarean section, after exhausting other conservative methods before the decision for hemostatic hysterectomy in 8 cases. Bleeding occurred in: primary atony 1 case, atony by fiber hyperdistension in 3 cases (twin pregnancy in 2 cases, negative labor test 1 case), lack of retraction of the lower segment by praevia insertion of placenta 1 case and uterine scar 3 cases.…”

Uterine Atony: Management Strategies

“…This technique does not require lower segment hysterotomy therefore it is a good option when PPH occurs following vaginal delivery (Hayman et al, 2002). It is faster, easier and less traumatic to the uterus.…”