Uterine compression U-sutures in primary postpartum hemorrhage after Cesarean section: fertility preservation with a simple and effective technique

Hackethal, Andreas; Brueggmann, Doerthe; Oehmke, Frank; Tinneberg, H.‐R.; Zygmunt, Marek; Muenstedt, Karsten

doi:10.1093/humrep/dem364

Cited by 60 publications

(73 citation statements)

References 33 publications

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“…7,8 Bu sütürlerin kullanımı ile hemostatik histerektomiden kaçınmak mümkün olmaktadır. 7,8,[12][13][14] Balon tamponad uygulaması, en hızlı ve en az invaziv cerrahi yöntem olarak kabul edilmektedir.…”

Section: Discussionunclassified

Management of Postpartum Haemorrhage Due to Uterine Anomalies or the Asymmetric Uterus Growth: Two Case Report and Literature Review

Alanbay¹,

Öztürk²,

Karaşahin³

2017

Turkiye Klinikleri J Gynecol Obst

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Section: Discussionunclassified

Management of Postpartum Haemorrhage Due to Uterine Anomalies or the Asymmetric Uterus Growth: Two Case Report and Literature Review

Alanbay¹,

Öztürk²,

Karaşahin³

2017

Turkiye Klinikleri J Gynecol Obst

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“…Since the bleeding did not cease, multiple uterine compression sutures-totally 8-by Hackethal technique were performed. 4 Polypropylene USP 1 (Prolene ® , Ethicon, USA) suture was used to cross through anterior and posterior walls of the uterus opposing two walls of the uterus which finally restored hemostasis. The patient was discharged at postoperative day four.…”

Section: Case Presentation 1: Synechiamentioning

confidence: 99%

“…Since BLynch suture was introduced in 1997, 3 numerous UCS have been described [Cho multiple square, Hayman, Pereira, Hackethal (interrupted U sutures)]. 4,5 There is no 'the best' suture yet and the success rate of compression sutures varies between 76-100% in the literature. 5 Lack of standardization of the procedures and the availability of only case series and stepwise uterine measures make it impossible to efficiently compare the efficacy of different UCS techniques.…”

Section: Introductionmentioning

confidence: 99%

Adverse Events after Uterine Compression Sutures for Postpartum Hemorrhage: Report of Three Cases and Review of the Literature

Cengiz

Çağlar

Gürsoy

et al. 2016

Gynecol Obstet Reprod Med

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Uterine compression sutures may be life and fertility saving interventions in management of uterine atony. However, unintended long-term outcomes may occur and there is scarce literature about management. Herein, management of long-term adverse outcomes (synechia, pelvic pain and pelvic collection) of three different cases who had to be treated by uterine compression sutures is reported with review of the literature.

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“…After failure of medical and conservative surgical measures [11] , emergency postpartum hysterectomy is often unavoidable. The loss of fertility especially in women delivering the fi rst child including an augmented mortality of preterm neonates often associated with pathologic placentation has a major psychologic impact.…”

Section: Commentmentioning

confidence: 99%

Recombinant human factor VIIa prevents hysterectomy in severe postpartum hemorrhage: single center study

Huber

Raio

Alberio

et al. 2012

Journal of Perinatal Medicine

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Objective: To evaluate the effectiveness of human recombinant activated factor VII (rhFVIIa, NovoSeven) in avoiding hysterectomy postpartum in the management of severe postpartum hemorrhage (PPH). Methods: We performed a prospective cohort study at our university tertiary care center. Patients with severe post partum hemorrhage (blood loss > 2000 mL) and failed medical and uterus-preserving surgical management, were treated with intravenous bolus administration of rhVIIa. Main outcome measures were cessation of bleeding, postpartum hysterectomy and thromboembolic events. Results: In 20/22 patients included, PPH was caused primarily by uterine atony, including 7 (32 % ) with additional lower genital tract lesion; in two women, it was due to pathologic placentation (placenta increta, 9 % ). One case of amniotic fl uid embolism and one woman with uterine inversion were included. Recombinant hFVIIa was successful in stopping the PPH and in preventing a hysterectomy in 20/22 women (91 % ). The remaining two patients with persistent bleeding despite rhFVIIa treatment, who underwent postpartum hysterectomy, had placenta increta. No thromboembolic event was noticed. Conclusions: This study describes the largest single center series of rhFVIIa treatment for fertility preservation in severe postpartum hemorrhage published to date. Our data suggest that administration of rhFVIIa is effective in avoiding postpartum hysterectomy after conservative medical and surgical measures have failed. Although randomized studies are lacking, rhFVIIa should be considered as a second-line therapeutic option of life-threatening postpartal bleeding, in particular if preservation of fertility is warranted and hysterectomy is to be avoided.

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Uterine compression U-sutures in primary postpartum hemorrhage after Cesarean section: fertility preservation with a simple and effective technique

Abstract: Uterine compression with U-sutures is a highly effective and straightforward emergency procedure which conserves the uterus in these patients.

Cited by 60 publications

References 33 publications

Management of Postpartum Haemorrhage Due to Uterine Anomalies or the Asymmetric Uterus Growth: Two Case Report and Literature Review

Management of Postpartum Haemorrhage Due to Uterine Anomalies or the Asymmetric Uterus Growth: Two Case Report and Literature Review

Adverse Events after Uterine Compression Sutures for Postpartum Hemorrhage: Report of Three Cases and Review of the Literature

Recombinant human factor VIIa prevents hysterectomy in severe postpartum hemorrhage: single center study

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