PUERPERIUM
Post-Partum Haemorrhage
|
Obstet Gynecol. 2007 Jul;110(1):68-71.
Uterine compression sutures for postpartum hemorrhage: efficacy, morbidity,
and subsequent pregnancy.
Baskett TF.
Department of Obstetrics and Gynaecology, Dalhousie University, Halifax,
Nova Scotia, Canada. tbaskett@ns.sympatico.ca
Objectives:
To review the efficacy, morbidity, and subsequent pregnancy
outcome after uterine compression sutures for severe postpartum hemorrhage.
Methods:
A 7-year review (2000-2006) of all uterine compression sutures for
postpartum hemorrhage at one tertiary obstetric hospital.
Results:
During
the 7 years, 28 uterine compression sutures were performed in 31,519
deliveries (1 per 1,126). All were done at the time of cesarean delivery: 22
in 4,870 cesarean deliveries in labor (1 in 221) and 6 in 3,819 elective
cesarean deliveries (1 in 637). The indications for suture were atonic
postpartum hemorrhage in 25 of 28 (89%), placenta previa in 2 of 28 (7%),
and partial placenta accreta in 1 of 28 (4%). Hysterectomy was avoided in 23
of 28 women (82%). Blood transfusion was needed in 13 of 28 (46%), and
intensive care in 5 of 28 (18%). Seven women had subsequent uncomplicated
term pregnancies, all delivered by elective repeat caesarean delivery.
Conclusion:
Uterine compression sutures for severe postpartum hemorrhage may
obviate the need for hysterectomy and appear not to jeopardize subsequent
pregnancy.
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