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Compressive suture of the lower uterine segment for the treatment of postpartum hemorrhage due to complete placenta
Mauro Penotti1, Paolo Vercellini, Giorgio Bolis
11st Department of Obstetrics and Gynecology, Istituto Ostetrico e Ginecologico Luigi Mangiagalli, University of Milan, Milan, Italy. mauro.penotti@libero.it
Aim:
To assess the efficacy of a uterine compression suture technique in controlling hemorrhage after removal of complete placenta previa during cesarean section.
Methods:
This prospective study was performed in a tertiary referral hospital and included 18 patients with postpartum hemorrhage following removal of complete placenta previa during elective cesarean section. All 18 patients underwent bilateral anteroposterior compression suture of the lower uterine segment. All patients were followed postpartum for evaluation of uterine cavity and menstrual cycles.
Results:
Anteroposterior compressive suture of the lower uterine segment achieved immediate complete hemostasis in all 18 patients. No surgical complication was observed. All patients recovered normal menstrual cycles. Normal patency of the uterine cavity was documented with sonohysterography in all patients at the 6-month follow-up visit.
Conclusions:
This quick and simple suture technique seems to be effective in stopping hemorrhage following complete placenta previa removal during cesarean section. Normal patency of the uterine cavity seems not to be impaired at medium-term follow-up.
