Removable retropubic uterine compression suture for controlling postpartum hemorrhage

Abstract

Objective To minimize the adverse events of uterine compression suture in controlling postpartum hemorrhage (PPH) and to search for a prophylactic approach to potential PPH. Methods A retrospective analysis was performed in 39 women with removable retropubic uterine compression suture (RRUCS) to stop PPH due to uterine atony during cesarean section (CS). The procedure was to suspend and compress the uterus to the retropubic abdominal wall using an absorbable suture. Results The technique was sufficient to stanch bleeding immediately in 36 patients (92.31%, 36/39). No morbidity or abnormalities occurred in women who underwent RRUCS. Subsequent pregnancies occurred in 10 cases, but the others lacked the desire for future pregnancy. Conclusion RRUCS is a simple, safe, and effective technique in controlling atonic PPH; it is also used as a prophylactic application in patients with potential PPH after CS.

A new step-wise surgical technique of knapsack-like uterine compression sutures for intractable postpartum hemorrhage in cesarean section

“…Removable retropubic uterine compression suture is to fold the body of the uterus into an excessive anterior flexion using absorbable sutures, which are then secured to the abdominal wall behind the pubic symphysis. This may be more effective in stopping hemorrhage in the base of the uterus or in weak contractions of the uterine body, but is highly invasive and there is some controversy over its application [ 33 ]. Regardless of the suture method, the local blood flow is rapidly reduced and the bleeding is stopped by the gradual formation of microthrombosis.…”

Uterine compression suture: Some procedures to reduce necrosis or synechia

“…(F) Removable retropubic uterine compression suture. 9 The uterus should be in a marked anteflexed position, which achieves hemostasis. The abdominal wall thread is cut and pulled out from the vagina using a vaginal cannula.…”

“…In the report by Li et al on "removable retropubic uterine compression suture," abdominal and vaginal threads compress the uterus against the pubic bone and abdominal wall in a marked anteflexed position with threads removed from the vagina (Figure 1F). 9 Nine years have passed since I proposed the concept of removable UCS. This concept has been realized and is being employed in clinical practice.…”

A new step-wise surgical technique of knapsack-like uterine compression sutures for intractable postpartum hemorrhage in cesarean section

“…Removable retropubic uterine compression suture is to fold the body of the uterus into an excessive anterior exion using absorbable sutures, which are then secured to the abdominal wall behind the pubic symphysis. This may be more effective in stopping hemorrhage in the base of the uterus or in weak contractions of the uterine body, but is highly invasive and there is some controversy over its application [22]. Regardless of the suture method, the local blood ow is rapidly reduced and the bleeding is stopped by the gradual formation of microthrombosis.…”