Uterine Compression Sutures in Controlling Postpartum Haemorrhage: A Narrative Review

Authors

  • Maria Lúcia Moleiro Departamento da Mulher e da Medicina Reprodutiva. Centro Materno Infantil do Norte. Centro Hospitalar Universitário do Porto. Porto. https://orcid.org/0000-0002-1807-5014
  • Jorge Braga Departamento da Mulher e da Medicina Reprodutiva. Centro Materno Infantil do Norte. Centro Hospitalar Universitário do Porto. Porto.
  • Maria João Machado Serviço de Neurocirurgia. Hospital de Braga. Braga.
  • Luís Guedes-Martins Departamento da Mulher e da Medicina Reprodutiva. Centro Materno Infantil do Norte. Centro Hospitalar Universitário do Porto. Porto. Unidade de Investigação e Formação. Centro Materno Infantil do Norte. Centro Hospitalar Universitário do Porto. Porto. Instituto de Investigação e Inovação em Saúde. Universidade do Porto. Porto. https://orcid.org/0000-0002-0491-0752

DOI:

https://doi.org/10.20344/amp.11987

Keywords:

Hysterectomy, Obstetric Labour Complications, Postpartum Hemorrhage, Sutures

Abstract

Introduction: Postpartum haemorrhage is still the main cause of maternal morbidity and mortality. Many treatments are available, but they may threaten fertility potential. As a uterine sparing procedure, we aimed to review uterine compression sutures in order to better understand when they should represent an appropriate option.
Material and Methods: A comprehensive search in MEDLINE and PubMed databases including the terms ‘postpartum haemorrhage’ and ‘uterine compression sutures’ was performed. Results were revised and articles reviewing or presenting case reports of uterine compression sutures to treat postpartum haemorrhage were included.
Results: The first description of uterine compression sutures to control postpartum haemorrhage was published in 1997, by B-Lynch et al. After this publication, many others have reported successful management of postpartum haemorrhage with different suturing techniques. Most of them describe success rates above 75% and the possibility of fertility preservation, with cases of uneventful pregnancy after uterine compression sutures already published. Complications associated with each technique are rare.
Discussion: Reports of use of uterine compression sutures include small series of cases or even single case reports which limits the quality of existing evidence to support one technique over another. Nevertheless, uterine compression sutures are recognized as an effective surgical conservative strategy to control postpartum haemorrhage due to uterine atony and its use is recommended, if possible, prior to hysterectomy.
Conclusion: Uterine compression sutures are effective, safe and simple to perform in an emergent situation and preserve fertility potential in cases of postpartum haemorrhage.

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Published

2022-01-03

How to Cite

1.
Moleiro ML, Braga J, Machado MJ, Guedes-Martins L. Uterine Compression Sutures in Controlling Postpartum Haemorrhage: A Narrative Review. Acta Med Port [Internet]. 2022 Jan. 3 [cited 2024 Jun. 24];35(1):51-8. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/11987

Issue

Section

Review Articles