title: Menstrual pattern and intrauterine adhesions after transuterine suture for postpartum hemorrhage.
abstract: OBJECTIVE
  To describe menstrual abnormalities and intrauterine adhesions within 5 years after a transuterine compression suture and uterine devascularization with hypogastric ligation.
  
  
  METHODS
  Prospective clinical follow-up was conducted on 56 patients who underwent uterine devascularization with hypogastric ligation and transuterine suture. The main outcomes were to investigate intrauterine adhesions, menstrual pattern, and desire for subsequent pregnancy and fertility.
  
  
  RESULTS
  Among 56 cases, abnormal placental implantation was diagnosed in 30 (53.6%) (Group 1), and uterine atony was diagnosed in 26 (46.4%) (Group 2). Before pregnancy, while 2/24 patients in Group 1 and 2/23 patients in Group 2 had menstrual irregularities, after pregnancy 8/24 patients in Group 1 and 9/23 patients in Group 2 had menstrual irregularities (p = 0.03 and 0.01, respectively). Hysteroscopic examination revealed normal findings in 16 patients in Group 1 (66.6%) and 20 patients in Group 2 (86.9%) (p > or = 0.05). Among patients who had desired a future pregnancy, 2 of 4 patients (50%) in Group 1 and 4 of 5 patients (80%) in Group 2 subsequently had achieved successful pregnancies.
  
  
  CONCLUSIONS
  Transuterine compression suture and uterine devascularization with hypogastric ligation in managing postpartum hemorrhage appear to have achieved preserved fertility and, in most cases, menstrual regularity.
authors.affiliation: Department of Obstetrics and Gynecology, Kocaeli University, Faculty of Medicine, Umuttepe/Uctepeler, 41000 Kocaeli, Turkey.
authors.forename: Eray
authors.initials: E
authors.lastname: Caliskan
authors.forename: Yigit
authors.initials: Y
authors.lastname: Cakiroglu
authors.forename: Oner
authors.initials: O
authors.lastname: Aynioglu
authors.forename: Sebiha
authors.initials: S
authors.lastname: Ozkan
authors.forename: Izzet
authors.initials: I
authors.lastname: Yucesoy
authors.forename: Aydin
authors.initials: A
authors.lastname: Corakci
mesh_terms: D000328:Adult; D005260:Female; D005298:Fertility; D006488:Hemostasis, Surgical; D006801:Humans; D008026:Ligation; D008599:Menstruation Disturbances / Q000453:epidemiology*; D006473:Postpartum Hemorrhage / Q000601:surgery*; D011247:Pregnancy; D013536:Suture Techniques / Q000009:adverse effects; D000267:Tissue Adhesions / Q000453:epidemiology; D014591:Uterine Diseases / Q000453:epidemiology; D014599:Uterus / Q000098:blood supply