Kriti Bhatnagar1, Surendra Kumar Gulati2, Smita Tyagi
OBJECTIVE
To study the efficacy and morbidity of uterine compression sutures in the management of intractable severe postpartum haemorrhage.
METHOD
A prospective study was done at Muzaffarnagar Medical College, Muzaffarnagar from Jan 2012 to June 2015. There were total 6149 deliveries and 1803 (29.4%) caesarean deliveries and 4346 (70.7%) were vaginal deliveries. Uterine compression sutures B-Lynch and modified B-Lynch (Hayman) sutures were applied in eight patients. A Vicryl No. 1 or catgut No. 2 sutures were used in straight round body needle. Patient was placed in modified lithotomy position to assess the compression effect of uterine compression suture.
RESULT
There were eight uterine compression sutures applied in 6149 deliveries (1:800). Five (62.5%) were applied at the time of caesarean and three (37.5%) were applied after vaginal or assisted vaginal deliveries. Hysterectomy was avoided in seven patients and one patient (12.5%) required hysterectomy for intractable bleeding due to DIC. Blood transfusions were given in all patients. Postoperative period was uneventful and there was no maternal death.
CONCLUSION
Uterine compression sutures should be considered in case of intractable postpartum haemorrhage (atonic) and it may obviate the need of hysterectomy and other procedures like hypogastric artery ligation, uterine artery/ovarian artery ligation.
