Rethinking uterine compression suture for atonic postpartum hemorrhage

Kondoh, Eiji; Ueda, Akihiko; Mogami, Haruta

doi:10.1111/aogs.14035

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…Despite the advantage of UCS being performed simultaneously with delivery, another possible reason may be related to its use for prophylactic purposes in some cases 32 . Kondoh et al 33 showed that vertical UCS techniques provided better hemostasis in hemorrhages originating from the upper uterine fundus center. In the H‐Hayman technique we describe, the center of the fundus was supported; therefore, this procedure may have provided better bleeding control.…”

Section: Discussionmentioning

confidence: 99%

Comparison of H‐Hayman uterine compression suture with conventional vertical sutures: A cross‐sectional study in a tertiary center

Denızlı

Farisoğulları

Sakcak

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo compare H‐Hayman, a modified uterine compression suturing technique (UCS) that we describe for the first time in the literature, with conventional vertical UCS techniques.MethodsThe H‐Hayman technique was used in 14 women and the conventional UCS technique in 21 women. In order to provide standardization in the study, only patients who had developed upper‐segment atony during cesarean section were recruited for the study.ResultsBleeding control was achieved in 85.7% (12/14) of the cases using the H‐Hayman technique. In the remaining two patients with persistent hemorrhage in this group, bleeding control was provided with bilateral uterine artery ligation, and a hysterectomy was avoided in all cases. With the conventional technique, bleeding control was achieved in 76.1% (16/21) of the patients, and the overall success rate was 95.2% after bilateral uterine artery ligation in those with persistent hemorrhage. In addition, the estimated blood loss and the need for erythrocyte suspension transfusion were significantly lower in the H‐Hayman group (P = 0.01 and P = 0.04, respectively).ConclusionWe found the H‐Hayman technique to be at least as successful as conventional UCS. In addition, patients who underwent suturing with the H‐Hayman technique had less blood loss and a lower requirement for erythrocyte suspension transfusion.

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Section: Discussionmentioning

confidence: 99%

Comparison of H‐Hayman uterine compression suture with conventional vertical sutures: A cross‐sectional study in a tertiary center

Denızlı

Farisoğulları

Sakcak

et al. 2023

Intl J Gynecology & Obste

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show abstract

“…We also present a treatment algorithm for atonic PPH (Figure 5). CT scan assessment of PRACE suggests that the effectiveness of conventional uterine compression sutures, including B‐Lynch sutures, depends on the location of the bleeding site 13 . If the bleeding site is lateral to the suture, uterine compression sutures will not achieve haemostasis.…”

Section: Innovative Ibt Techniques For Haemostasis Of Refractory Pphmentioning

confidence: 99%

“…CT scan assessment of PRACE suggests that the effectiveness of conventional uterine compression sutures, including B-Lynch sutures, depends on the location of the bleeding site. 13 If the bleeding site is lateral to the suture, uterine compression sutures will not achieve haemostasis. Since the bleeding site can be easily determined by CT scan, it will be common in the future to try haemostatic uterine sutures targeting the bleeding site before hysterectomy.…”

Section: Innovative Ibt Techniques For Haemostasis Of Refractory Pphmentioning

confidence: 99%

CT scan assessment of intrauterine balloon tamponade failure for the treatment of atonic postpartum haemorrhage: implications for treatment

Kondoh

Chigusa

Ueda

et al. 2021

BJOG

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Factors linked to early adverse neonatal outcomes in diabetic pregnant women at selected Ugandan hospitals: A prospective cohort study

Namutebi,

Kasujja,

Bagambe

et al. 2024

Preprint

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Background Diabetes mellitus during pregnancy is associated with increased risks of adverse neonatal outcomes. Understanding the incidence and factors contributing to these outcomes is crucial for improving maternal and neonatal health in low-resource settings. Methods This prospective cohort study enrolled 150 pregnant women with diabetes mellitus delivering at Jinja, Hoima, and Lira Regional Referral Hospitals in Uganda. Data on socio-demographic characteristics, obstetric history, and neonatal outcomes were collected using standardized protocols. Logistic regression analyses were performed to assess associations between maternal characteristics and adverse neonatal outcomes. Results The incidence of adverse neonatal outcomes was 69.3%. Specific outcomes included macrosomia (45.3%), low APGAR scores (4–6: 28.0%, < 3: 7.3%), NICU admission (27.3%), hypoglycaemia (25.3%), respiratory distress (20.7%), early neonatal death (14.0%), birth injuries (7.3%). Significant factors associated with adverse outcomes included unemployment (aOR = 5.94, 95%CI = 1.70-20.67, p = 0.005), fewer than four antenatal care visits (aOR = 1.63, 95%CI = 1.24–16.49, p = 0.035), preterm delivery (aOR = 3.57, 95%CI = 1.06–12.03, p = 0.040), and not receiving treatment for maternal diabetes (aOR = 1.93, 95%CI = 1.05–4.36, p = 0.016). In contrast, a monthly income of ≥ 150,000 was protective against adverse outcomes (aOR = 0.18, 95%CI = 0.06–0.57, p = 0.004). Conclusions The study revealed a high incidence of adverse neonatal outcomes among mothers with diabetes, highlighting the urgent need for improved care. Key factors linked to these adverse outcomes included unemployment, fewer antenatal care visits, preterm delivery, and lack of maternal diabetes treatment, while higher monthly income was protective. Targeted interventions, such as enhanced antenatal care and effective diabetes management, are essential to reduce adverse neonatal outcomes. Future research should focus on evaluating specific interventions to mitigate these risks and improve maternal and neonatal health in similar low-resource settings.

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Rethinking uterine compression suture for atonic postpartum hemorrhage

Cited by 3 publications

References 11 publications

Comparison of H‐Hayman uterine compression suture with conventional vertical sutures: A cross‐sectional study in a tertiary center

Comparison of H‐Hayman uterine compression suture with conventional vertical sutures: A cross‐sectional study in a tertiary center

CT scan assessment of intrauterine balloon tamponade failure for the treatment of atonic postpartum haemorrhage: implications for treatment

Factors linked to early adverse neonatal outcomes in diabetic pregnant women at selected Ugandan hospitals: A prospective cohort study

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