Uterine Compression Sutures in Controlling Postpartum Haemorrhage: A Narrative Review

Abstract

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.

Removable retropubic uterine compression suture for controlling postpartum hemorrhage

“…Different from Matsubara's and Aboulfalah's removable UCS per the abdominal wall, our RRUCS is not only convenient for postoperative removal of the threads, but also has less puncture points on the uterus and the abdominal wall, thereby minimizing the adverse events of UCS. Its success rate in instant bleeding stoppage was 92.31% (36/39), which matched those of other authors' reports 1, 3, 5, 6, 19–22 . Moreover, no adverse events were detected in women who underwent RRUCS.…”

“…Complications after UCS have attracted obstetricians' attention for decades, and various approaches to solve the problem have been constantly searched. Some adverse events, such as uterine ischemia, erosion, necrosis, rupture, synechia, infection, reinversion, irregular menstruation, and menstruation‐associated symptoms or depression, have been repeatedly described following UCS 7–10, 17–24 . Seidel et al 25 reported a patient with vaginal omentum prolapse after prophylactic UCS, in whom a hysterectomy was performed owing to serious uterine necrosis, infection, and destruction.…”

Plasenta invazyon anomalisi olan ve olmayan plasenta previa vakalarında risk faktörleri, yönetim ve perinatal sonuçlar

“…In a review published in 2019 regarding uterine compression sutures, the success rate of different compression suture techniques in postpartum bleeding was reported between 36% and 98%. In the same review, since there hadn't been any randomized controlled studies comparing suture techniques in the literature, it was suggested that suture technique selection should be made according to the surgeon's knowledge and experience regarding the case (23).…”

http://www.sogvzla.org.ve/sogvzla20186/cms/svcobtenerpdfrevista.php?id=0000000104&tipo=normal&fila=3

“…La literatura existente ha encontrado que la atonía uterina como representante más común de la hemorragia posparto está asociada a un alto índice de muertes maternas a nivel mundial (14). Este estudio refleja la efectividad de la técnica de B-Lynch como tratamiento en la hemorragia por atonía uterina, permitiendo la preservación del útero y la fertilidad.…”