Transverse annular compression sutures in the lower uterine segment to control postpartum hemorrhage at cesarean delivery for complete placenta previa

Compressive Suture of the Lower Uterine Segment for the Treatment of Postpartum Hemorrhage due to Complete Placenta Previa: A Preliminary Study

“…In 2010, Ying et al [6] proposed a transverse annular compression suture in comparison with uterine packing. In this study, the transverse annular compression suture appeared quicker and more effective in reducing blood transfusion in comparison to packing.…”

“…However, because of the poorly contractile nature of the lower uterine segment, this hemorrhage cannot usually be treated pharmacologically. In these circumstances, several modalities to reduce bleeding have been suggested, including packing the lower uterine segment with gauze [6], oversewing the implantation site with interrupted sutures [6], performing a stepwise uterine vessels ligation [7], compressing the uterus with an original or modified B-Lynch procedure [8], ligating internal iliac arteries [9], embolizing pelvic arteries [3], and, finally, resorting to a hemostatic hysterectomy [5]. …”

Vertical compression sutures for control of postpartum hemorrhage from a placenta previa in cesarean section — To evaluate the usefulness of this technique

“…Moreover, many of these women develop disseminated intravascular coagulation (DIC) shortly after this massive hemorrhage, which makes hemostasis even more difficult. Various methods to reduce this massive hemorrhage have been suggested, such as intrauterine gauze packing, 1) interrupted sutures, 1) stepwise uterine vessel ligation, 2) internal iliac artery ligation, 3) original or modified B-Lynch sutures, 4,5) transcatheter arterial embolization (TAE), 6) use of Bakri balloon tamponade, 7,8) and hysterectomy. 9) In 2005, Hwu et al 10) reported their use of vertical compression sutures (VCS) as a method of controlling hemorrhage from the separated surface of the lower uterine segment in cases of placenta previa or placenta accreta.…”

Three cornerstones of uterine compression sutures: simplicity, safety and efficacy

“…(1) Uterine atony, e.g., B-Lynch suture [ [12] (3) Crisscrossing suture, e.g., M-Y suture [13] (4) Sutures around the uterus, e.g., Pereira suture [10] 5. According to whether the sutures transfix uterine cavity:…”