If medical management is unsuccessful in controlling postpartum hemorrhage, conservative surgical intervention or cesarean hysterectomy is required.
Hemostatic multiple square suturing using a straight number 7 or number 8 needle and number 1 chromic catgut is a new surgical technique to approximate anterior and posterior uterine walls, especially in areas where there is heavy bleeding. It controls postpartum hemorrhage by attachment and compression of the hemorrhage site of the endometrium or myometrium.
We used this technique in 23 women with postpartum hemorrhages at cesarean who did not respond to conservative treatment. In all 23 cases, bleeding decreased markedly and hysterectomy was avoided. All resumed normal menstrual flow after surgery. In four cases, further pregnancy was achieved after this method was used.
Hemostatic multiple square suturing is an easy, safe, conservative surgical alternative to hysterectomy for treating uncontrollable postpartum hemorrhage.
Hemostatic multiple square sutures make an easy, safe, conservative surgical alternative to hysterectomy for uncontrollable postpartum hemorrhage.
Department of Obstetrics and Gynecology, Pochon Cha University College of Medicine, Cha General Hospital, Seoul, Korea.
Address reprint requests to: Jin Ho Cho, MD, Department of Obstetrics & Gynecology, Pundang Cha General Hospital, 351 Yatapdong, Pundang-Gu, Sungnam, Kyonggido 463-712, Korea; E-mail: firstname.lastname@example.org
Received July 8, 1999. Received in revised form January 31, 2000. Accepted February 10, 2000.