title: Reflexed Compression Suture for the Management of Atonic Postpartum Hemorrhage with an Abnormally Adherent Placenta.
abstract: OBJECTIVE
  Postpartum hemorrhage (PPH) is a life-threatening condition with a worldwide occurrence. The purpose of this study is to evaluate the efficacy and safety of a reflexed compression suture in controlling severe atonic PPH with placenta accreta.
  
  
  METHODS
  Eleven women with severe PPH due to uterine inertia or placenta accreta were administered the reflexed compression suture. The procedure was to reflex the fundus onto the anterior wall of the uterus for compressing hemostasis and to form a 'belt-like' binding suture to reinforce the effectiveness of pressing the myometrium.
  
  
  RESULTS
  Ten of the 11 women (90.9%) were successfully treated with the suture, and the uterus was preserved. None of these patients developed complications related to this method. Only in 1 patient with placenta increta could the bleeding not be stanched, and a peripartum hysterectomy was performed. Two women had pregnancies after the suture.
  
  
  CONCLUSIONS
  The reflexed compression suture is a simple, swift, safe and effective technique of controlling uterine atonic bleeding, particularly in patients with an abnormally adherent placenta. The advantage of not having to conduct a hysterotomy also lies in reducing the duration of anesthesia and blood loss.
authors.affiliation: Department of Obstetrics and Gynecology, China Meitan General Hospital,, Beijing, PR China.
authors.forename: Guang Tai
authors.initials: GT
authors.lastname: Li
authors.forename: Xiao Fan
authors.initials: XF
authors.lastname: Li
authors.forename: Ji
authors.initials: J
authors.lastname: Li
authors.forename: Ya Jing
authors.initials: YJ
authors.lastname: Liu
authors.forename: Hong Mei
authors.initials: HM
authors.lastname: Xu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D013513:Obstetric Surgical Procedures / Q000379:methods*; D010921:Placenta Accreta; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000601:surgery*; D011247:Pregnancy; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult