title: Uterine compression sutures for postpartum hemorrhage: is routine postoperative cavity evaluation needed?
abstract: Postpartum hemorrhage due to uterine atony continues to be one of the major causes of maternal morbidity and mortality. Several uterine compression suture techniques have been described and are increasingly being used worldwide as a conservative approach. However, little is known about the long-term effects on the uterine cavity, as well as fertility and pregnancy outcomes. We reviewed the reported complications and uterine findings after the use of compression sutures, both in examinations to evaluate the cavity (hysteroscopy, hysterosalpingography or sonohysterography) and at cesarean section, in order to assess the possible usefulness of routine postoperative cavity evaluation. Overall, the use of uterine compression sutures is effective and safe; however, some severe and potentially life-threatening complications have been reported and could possibly have been prevented if uterine cavity evaluation had been performed. Routine follow-up, both by hysteroscopy and an imaging technique, seems worthwhile.
authors: Department of Obstetrics and Gynecology, S. João Hospital, Porto, Portugal. celia.m.costa@hotmail.com
authors: Célia
authors: C
authors: Amorim-Costa
authors: Raquel
authors: R
authors: Mota
authors: Claudio
authors: C
authors: Rebelo
authors: Pedro Tiago
authors: PT
authors: Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods; D005260:Female; D006488:Hemostasis, Surgical / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D008991:Monitoring, Physiologic / Q000379:methods*; D007744:Obstetric Labor Complications / Q000503:physiopathology / Q000601:surgery; D011182:Postoperative Care / Q000379:methods; D006473:Postpartum Hemorrhage / Q000401:mortality / Q000601:surgery*; D011247:Pregnancy; D011312:Pressure; D011379:Prognosis; D018570:Risk Assessment; D015996:Survival Rate; D013536:Suture Techniques; D013537:Sutures; D013718:Tensile Strength; D016896:Treatment Outcome; D055815:Young Adult