Uterine cavity synechiae after hemostatic square suturing technique.
BACKGROUND
A number of surgical techniques to control severe bleeding at cesarean delivery have been proposed, such as uterine artery ligation, hypogastric artery ligation, and uterine compression suturing.


METHODS
A primigravida with severe postpartum hemorrhage and disseminated intravascular coagulopathy had multiple square sutures placed through the uterus. Serial sonographic follow-up studies revealed uterine synechiae with partial obstruction of menstrual flow. Hysteroscopy confirmed unabsorbed sutures in the uterine cavity.


CONCLUSIONS
The use of multiple sutures through the uterus is effective to control postpartum hemorrhage but may lead to uterine synechiae.
Wu
Hsin-Hung
HH
Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan. 58436@cch.org.tw
Yeh
Guang-Perng
GP
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D006473:Postpartum Hemorrhage / Q000175:diagnosis / Q000601:surgery*; D011247:Pregnancy; D012086:Reoperation; D018570:Risk Assessment; D013536:Suture Techniques / Q000009:adverse effects*; D013537:Sutures / Q000009:adverse effects; D000267:Tissue Adhesions / Q000175:diagnosis* / Q000601:surgery; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler