Uterine mesh compression suturing for refractory postpartum hemorrhage: a retrospective study of 45 cases

To evaluate the clinical application and efficacy of a novel suturing technique-uterine mesh compression suturing-in the treatment of refractory postpartum hemorrhage.

A retrospective analysis was performed on the clinical data of 45 patients with refractory postpartum hemorrhage who underwent uterine mesh compression suturing. The surgical efficacy and safety were systematically evaluated.

Active uterine bleeding was controlled in all patients within 10 min postoperatively. The cumulative vaginal bleeding volume at 2 h post-surgery was less than 20 mL, indicating effective hemostasis. MRI on postoperative day 4 revealed scattered punctate signals in the uterine wall, with no intrauterine fluid accumulation. At 42 days post-surgery, MRI showed a uniform signal in the myometrium and a clear endometrial line. Ultrasound at 42 days post-surgery demonstrated normal uterine size, uniform myometrial echogenicity, and good healing. Hysteroscopy at 6 months post-surgery revealed no intrauterine adhesions and clear fallopian tube ostia. All 45 patients resumed normal menstrual cycles 1-2 months after cessation of breastfeeding. Ten patients became pregnant again postoperatively: four underwent repeat cesarean deliveries, and six had artificial abortions.

Uterine mesh compression suturing is an effective method for controlling refractory postpartum hemorrhage. This technique can be used as an intervention for patients with refractory postpartum hemorrhage unresponsive to traditional hemostatic methods, or those with blood loss ≥1,500 mL during cesarean section. It holds promise for broader clinical application.