Hemostatic suturing technique for uterine bleeding during cesarean delivery.
BACKGROUND
If medical management is unsuccessful in controlling postpartum hemorrhage, conservative surgical intervention or cesarean hysterectomy is required.


METHODS
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.


RESULTS
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.


CONCLUSIONS
Hemostatic multiple square suturing is an easy, safe, conservative surgical alternative to hysterectomy for treating uncontrollable postpartum hemorrhage.
Department of Obstetrics and Gynecology, Pochon Cha University College of Medicine, Cha General Hospital, Seoul, Korea. obgy@hotmail.com
J H
JH
Cho
H S
HS
Jun
C N
CN
Lee
D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D011247:Pregnancy; D011644:Puerperal Disorders / Q000601:surgery*; D013536:Suture Techniques; D014592:Uterine Hemorrhage / Q000209:etiology / Q000601:surgery*