Investigation of perioperative complications associated with use of uterine compression sutures

Suzuki, Yosuke; Matsuzaki, Shinya; Mimura, Kazuya; Kumasawa, Keiichi; Tomimatsu, Takuji; Endo, Masayuki; Kimura, Tadashi

doi:10.1002/ijgo.12249

Cited by 16 publications

(15 citation statements)

References 27 publications

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“…Other articles reported rates less than our as Hüseyin Cengiz and all [24]: "Organ preserving surgery methods were utilized in all the patients with a success rate 78.9%". In addition to the absence of any of the complications described in literature [11]- [19], we noted during the follow-up, another benefit, which is the absence of isthmocoel in all patients with a median follow-up of 12 months, as shown in Picture 3.…”

Section: Discussionsupporting

confidence: 57%

“…At the same time, this anterior uterus wall "tie" helps narrow the uterine arteries lumen by tracting both left and right uterine arteries medially and also it helps lifting the anterior wall of the uterus and at the same time narrowing the uterine cavity. The merit of this technique in comparison with other compressive suturing techniques as Cho's multiple square suture, B-Lynch "Brace" suture, Hayman suture, Matsubara-Yano suture and many others described in literature[11]-[19] is that: it preserves the integrity of the uterine cavity, it's easy to perform with an average time esti-mated at 3 minutes (4 -5 minutes) and until the writing of this article we have not observed any complication at all. We usually decide to use this technique in moderate cases of postpartum hemorrhage and we are going to show in base of statistics its usefulness.…”

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confidence: 95%

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A New Surgical Way to Face Postpartum Hemorrhage

Abdelmounaim¹,

Biougnach²,

Rabea³

et al. 2020

OJOG

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Objective: We introduced two novel hemostatic techniques to achieve hemostasis for postpartum hemorrhage (PPH). The first one (A: Uterus Isthmic Plication) was a new uterine compression suture, which compresses the hysterotomy site. In a severe case, we further added vessel ligation suture after performing A-suture (B-combination suture: B-suture: A + Wide Lateral Uterine Vascular Ligation). Methods: Of 140 PPH cases, 90 were with mild PPH and 40 were with severe PPH. Our policy was: perform A-suture to mild PPH and perform B (combination) to severe PPH. Study was performed during 2018-2019. The primary endpoint to evaluate the efficacy of the procedures was preserving the uterus (no hysterectomy). Results: A-procedure, performed to 90 patients with mild PPH, was effective to all 90 patients, with all preserving the uterus. B-procedure, performed 38 patients with severe PPH (excluding two patients with uterine rupture), was effective in 37 patients, with one having undergone hysterectomy due to coagulopathy. Conclusion: Uterus Isthmic Plication (A-procedure) and addition of Wide Lateral Uterine Vascular Ligation to procedure-A (B-procedure) achieved hemostasis in patients with PPH. Prospective study is necessary to confirm the present data.

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Section: Discussionsupporting

confidence: 57%

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confidence: 95%

A New Surgical Way to Face Postpartum Hemorrhage

Abdelmounaim¹,

Biougnach²,

Rabea³

et al. 2020

OJOG

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“…The cases described by Nelson and O'Brien, 29 which involved the uterine sandwich technique, were all successful in controlling postpartum haemorrhage, but the authors outlined one patient who developed endomyometritis and another with postpartum oliguria. The risk of endometritis has also been reported by Suzuki et al 42 when evaluating perioperative complications of UCS in their hospital.…”

Section: Complications Related To Uterine Compression Suturesmentioning

confidence: 55%

Uterine Compression Sutures in Controlling Postpartum Haemorrhage: A Narrative Review

Moleiro¹,

Braga²,

Machado

et al. 2022

Acta Med Port

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Introduction: Postpartum haemorrhage is still the main cause of maternal morbidity and mortality. Many treatments are available, but they may threaten fertility potential. As a uterine sparing procedure, we aimed to review uterine compression sutures in order to better understand when they should represent an appropriate option.Material and Methods: A comprehensive search in MEDLINE and PubMed databases including the terms ‘postpartum haemorrhage’ and ‘uterine compression sutures’ was performed. Results were revised and articles reviewing or presenting case reports of uterine compression sutures to treat postpartum haemorrhage were included.Results: The first description of uterine compression sutures to control postpartum haemorrhage was published in 1997, by B-Lynch et al. After this publication, many others have reported successful management of postpartum haemorrhage with different suturing techniques. Most of them describe success rates above 75% and the possibility of fertility preservation, with cases of uneventful pregnancy after uterine compression sutures already published. Complications associated with each technique are rare.Discussion: Reports of use of uterine compression sutures include small series of cases or even single case reports which limits the quality of existing evidence to support one technique over another. Nevertheless, uterine compression sutures are recognized as an effective surgical conservative strategy to control postpartum haemorrhage due to uterine atony and its use is recommended, if possible, prior to hysterectomy.Conclusion: Uterine compression sutures are effective, safe and simple to perform in an emergent situation and preserve fertility potential in cases of postpartum haemorrhage.

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“…Postpartum hemorrhage (PPH) occurs in 4% to 6% of deliveries, and 80% of cases are caused by atonic bleeding. [1][2][3] Severe PPH is an obstetric emergency that occurs in 1% to 2% of live births and accounts for approximately 140,000 maternal deaths annually worldwide. 4 Treatment strategies include pharmacological measures (eg, oxytocin administration), intrauterine tamponade (eg, Bakri balloon or Sengstaken-Blakemore tube), uterine artery ligation, hysterectomy, uterine compression sutures, and uterine artery embolization (UAE).…”

Section: Introductionmentioning

confidence: 99%

<p>Obstetric Outcomes of Pregnancy After Uterine Artery Embolization</p>

Jitsumori¹,

Endo²,

Hara³

et al. 2020

IJWH

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Background: Uterine artery embolization (UAE) is used to treat severe postpartum hemorrhage (PPH). According to a few studies, UAE for PPH was associated with preterm birth, fetal growth restriction (FGR), and placenta accreta spectrum (PAS) in subsequent pregnancies. These previous studies, however, lacked controls, and to the best of our knowledge, no systematic literature reviews have been conducted thus far. We report the results of our retrospective case-control study of pregnancies after UAE at a single center and include a literature review to evaluate the risk of PAS in pregnancies after UAE. Methods: We retrospectively reviewed data from deliveries at our hospital between January 2012 and October 2017. We divided the delivery data into cases with previous UAEs performed for PPH (the post-UAE group) and those without UAEs (the non-UAE group, which included women without previous PPH). We defined PAS as cases in which hysterectomy was performed and pathological examination confirmed the diagnosis. Results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). Results: We used data from 3155 patients in this study, of whom 16 patients had undergone UAE (post-UAE group) and 3139 had not (non-UAE group). We found no differences between the groups in terms of frequency of preterm births (12.5% versus 14.2%, respectively; OR, 0.863; 95% CI, 0.218 to 3.414; P = 0.84) or FGR (6.2% versus 10.0%, respectively; OR, 0.602; 95% CI, 0.104 to 3.584; P = 0.61). However, cases of PAS were significantly more common in the post-UAE group (37.5%) than in the non-UAE group (1.2%; OR, 50.303; 95% CI, 17.38 to 145.592; P < 0.01). Conclusion: Our results suggest that previous UAE is a significant risk factor for PAS.

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Investigation of perioperative complications associated with use of uterine compression sutures

Abstract: Use of UCSs during emergency cesarean delivery might increase the risk of postoperative endometritis.

Cited by 16 publications

References 27 publications

A New Surgical Way to Face Postpartum Hemorrhage

A New Surgical Way to Face Postpartum Hemorrhage

Uterine Compression Sutures in Controlling Postpartum Haemorrhage: A Narrative Review

<p>Obstetric Outcomes of Pregnancy After Uterine Artery Embolization</p>

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