Multiple square sutures for postpartum hemorrhage: results and hysteroscopic assessment

Autor: Pascal Megier, Louis Mesnard, Souhail Alouini, Bruno Lemaire, Alain Desroches, Sekou Coly
Rok vydání: 2011
Předmět:
Zdroj: American journal of obstetrics and gynecology. 205(4)
ISSN: 1097-6868
Popis: Objective The purpose of this study was to evaluate the efficiency and morbidity of multiple square sutures in severe postpartum hemorrhage. Study Design A retrospective study encompassed 30 multiple square sutures that were performed for severe postpartum hemorrhage in 26,605 deliveries in a tertiary maternity center. The main outcome measures were the ability to stop hemorrhage and the assessment of the uterine cavity by hysteroscopy at 3 months. Results Multiple square sutures stopped postpartum hemorrhage in 28 of 30 cases (93%). Twenty women underwent hysteroscopy after multiple square sutures. Eight women (40%) did not have intrauterine adhesions. Nine women (45%) had thin and localized intrauterine adhesions that were removed easily by the tip of the hysteroscope; 2 women had moderate intrauterine adhesions that were resected. One patient had endometritis followed by severe intrauterine adhesions. Conclusion Multiple square sutures are effective and safe for the control of severe postpartum hemorrhage and for uterine conservation in most cases. Although some patients had moderate or severe adhesions, a normal uterine cavity or minimal intrauterine adhesions that were removed easily were the most frequent findings at hysteroscopy. A prospective study may be helpful to compare the safety and efficiency of square and brace sutures.
Databáze: OpenAIRE
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