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Uterine Compression Sutures for Postpartum Hemorrhage

Efficacy, Morbidity, and Subsequent Pregnancy

From the Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, Nova Scotia, Canada.

OBJECTIVE: 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.

LEVEL OF EVIDENCE: III

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