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The use of compression sutures in cases of massive postpartum haemorrhage uncontrolled by med-ical management gives an option to the women for future child bearing and menstrual function. A case is being reported wherein patient was referred in prolonged second stage of labour with failed forceps and intrapartum fetal demise. Emergency caesarean section was done and Hayman’s sutures were placed for massive atonic PPH with failed medical management. Patient developed subinvolution of uterus with py-operitoneum. Patient refused surgical intervention and later presented with necrosed uterine wall hanging through the introitus. Exploratory laparotomy showed total uterine necrosis with pyoperitoneum. A total hysterectomy with right salpingo-oophorectomy was done. Keywords: postpartum haemorrhage, uterine compression sutures, pyoperitoneum, uterine necrosis

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Introduction: Dysfunctional Uterine Bleeding, is Abnormal uterine bleeding in the absence of organic, systemic, iatrogenic cause. 1 Norethisterone acetate is commoly used progesterone derivative for management. 2 Ormeloxifene, a selective estrogen receptor modulator is an another alternate treatment for DUB. 3 Study was conducted at MVJ Medical College Bangalore. Objective: to compare treatment efficacy and usefulnes of Ormeloxifene and oral progesterone in DUB treatment. Materials and Methods: Total of 60 perimenopausal women with DUB were enrolled in our prospective study. They were randomly assigned to group A and group B. Group A: 30 women with DUB were treated with 60mg Ormeloxifene two times a week for 3 months, 60mg weekly once for next 3 months. Group B: Norethisterone 5 mg two times a day for 21 days for 6 cycles. Results: In our study even though Norethistrone group showed significant reduction in blood loss and also increase in haemoglobin level, these results were significantly less when compared with Ormeloxifene group. In addition Ormeloxifene group showed significant reduction in endometrial thickness, which was not significantly reduced in Norethisterone group. As a result of significant reduction of endometrial thickness among the women treated with Ormeloxifene. Conclusion: In the study Ormeloxifene was found to be effective than Norethisterone in reducing blood loss, improving Haemoglobin level and reducing endometrial thickness for treating DUB patients. Also compliance of the patients was good because drug was well tolerated, convenient dosage schedule for treatment of DUB.