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Archives of Gynecology and Obstetrics

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01-02-2015 | Maternal-Fetal Medicine

Symbol “&” suture to control atonic postpartum hemorrhage with placenta previa accreta

Authors: Guang Tai Li, Xiao Fan Li, Ya Jing Liu, Wei Li, Hong Mei Xu

Published in: Archives of Gynecology and Obstetrics | Issue 2/2015

Abstract

Objective

To evaluate the efficacy and safety of a symbol “&” compression suture technique in controlling severe atonic postpartum hemorrhage with placenta previa accreta during cesarean delivery.

Methods

Nine women with heavy postpartum bleeding from uterine inertia and placenta previa percret, which did not react to conventional initial management protocols, were underwent the suture in the shape of symbol “&” in China Meitan General Hospital. The suture procedure was to staple the anterior and posterior walls (of the lower uterine segment as well as corpus uterus) together using number 1 chromic catgut, with a cross at about 2 cm above the upper boundary of lower uterine segment.

Results

Symbol “&” compression suture was capable of stanching the postpartum hemorrhage immediately in all nine women. None of these patients developed complications related to this method. Subsequent pregnancies after the suture were occurred in two women and delivered with repeat cesarean section.

Conclusion

Symbol “&” compression suture is a simple, safe and highly effective technique to control the treatment-resistant uterine atonic bleeding, particularly in previous cesarean scar at lower segment and placenta previa accreta.

Devine PC (2009) Obstetric hemorrhage. Semin Perinatol 33(1):76–81CrossRefPubMed

Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM et al (2010) Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet 375(9726):1609–1623CrossRefPubMed

Ajenifuja KO, Adepiti CA, Ogunniyi SO (2010) Postpartum haemorrhage in a teaching hospital in Nigeria: a 5-year experience. Afr Health Sci 10(1):71–74PubMedCentralPubMed

Sentilhes L, Trichot C, Resch B, Sergent F, Roman H, Marpeau L (2008) Fertility and pregnancy outcomes following uterine devascularization for severe postpartum haemorrhage. Hum Reprod 23(5):1087–1092CrossRefPubMed

Koh E, Devendra K, Tan LK (2009) B-Lynch suture for the treatment of uterine atony. Singap Med J 50(7):693–697

ACOG Practice Bulletin (2006) Clinical management guidelines for obstetrician–gynecologists. Number 76, October 2006: postpartum hemorrhage. Obstet Gynecol 108(4):1039–1047CrossRef

Ahonen J, Stefanovic V, Lassila R (2010) Management of post-partum haemorrhage. Acta Anaesthesiol Scand 54(10):1164–1178CrossRefPubMed

Devine PC (2009) Obstetric hemorrhage. Semin Perinatol 33(2):76–81CrossRefPubMed

Breathnach F, Geary M (2009) Uterine atony: definition, prevention, nonsurgical management, and uterine tamponade. Semin Perinatol 33(2):82–87CrossRefPubMed

10.

Rath W, Hackethal A, Bohlmann MK (2012) Second-line treatment of postpartum haemorrhage (PPH). Arch Gynecol Obstet 286(3):549–561CrossRefPubMed

11.

Mallappa Saroja CS, Nankani A, El-Hamamy E (2010) Uterine compression sutures, an update: review of efficacy, safety and complications of B-Lynch suture and other uterine compression techniques for postpartum haemorrhage. Arch Gynecol Obstet 281(4):581–588CrossRefPubMed

12.

Hayman RG, Arulkumaran S, Steer PJ (2002) Uterine compression sutures: surgical management of postpartum hemorrhage. Obstet Gynecol 99(3):502–506CrossRefPubMed

13.

Cho JH, Jun HS, Lee CN (2000) Hemostatic suturing technique for uterine bleeding during cesarean delivery. Obstet Gynecol 96(1):129–131CrossRefPubMed

14.

Tjalma WA, Jacquemyn YA (2004) Uterus-saving procedure for postpartum hemorrhage. Int J Gynaecol Obstet 86(3):396–397CrossRefPubMed

15.

Hwu YM, Chen CP, Chen HS, Su TH (2005) Parallel vertical compression sutures: a technique to control bleeding from placenta praevia previa or accreta during caesarean section. Br J Obstet Gynaecol 112(10):1420–1423CrossRef

16.

Ouahba J, Piketty M, Huel C, Azarian M, Feraud O, Luton D et al (2007) Uterine compression sutures for postpartum bleeding with uterine atony. Br J Obstet Gynaecol 114(5):619–622CrossRef

17.

Steins Bisschop CN, Schaap TP, Vogelvang TE, Scholten PC (2011) Invasive placentation and uterus preserving treatment modalities: a systematic review. Arch Gynecol Obstet 284(2):491–502PubMedCentralCrossRefPubMed

18.

Bhal K, Bhal N, Mulik V, Shankar L (2005) The uterine compression suture—avaluable approach to control major haemorrhage at lower segment caesarean section. J Obstet Gynaecol 25(1):10–14CrossRefPubMed

19.

Hackethal A, Brueggmann D, Oehmke F, Tinneberg H-R, Zygmunt MT, Muenstedt K (2008) Uterine compression U-sutures in primary postpartum hemorrhage after cesarean section: fertility preservation with a simple and effective technique. Hum Reprod 23(1):74–79CrossRefPubMed

20.

Dedes I, Ziogas V (2008) Circular isthmic-cervical sutures can be an alternative method to control peripartum haemorrhage during caesarean section for placenta praevia accreta. Arch Gynecol Obstet 278(6):555–557CrossRefPubMed

21.

Matsubara S, Yano H, Ohkuchi A, Kuwata T, Usui R, Suzuki M (2013) Uterine compression sutures for postpartum hemorrhage: an overview. Acta Obstet Gynecol Scand 92(4):378–385CrossRefPubMed

Title: Symbol “&” suture to control atonic postpartum hemorrhage with placenta previa accreta
Authors: Guang Tai Li
Xiao Fan Li
Ya Jing Liu
Wei Li
Hong Mei Xu
Publication date: 01-02-2015
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 2/2015
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-014-3502-3

At a glance: The STEP trials

Springer Medicine

Symbol “&” suture to control atonic postpartum hemorrhage with placenta previa accreta

Abstract

Objective

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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