title: [Obstetric outcomes after uterine compression suture for treatment of postpartum hemorrhage: Long-term monitoring of 40 cases].
abstract: OBJECTIVE
  Uterine atony is the first cause of postpartum hemorrhage. In caesarean section, different techniques of uterine compression suture exist when uterotonic drugs fail. Their effectiveness is shown but little data on their effects on subsequent pregnancies are available. The aim of this work is analyze of the obstetrical long-term consequences after uterine compression suture.
  
  
  METHODS
  This is a retrospective study of 40 cases of uterine compression suture performed in a level III maternity, between 2004 and 2010. The main objective is the evaluation of the obstetrical prognosis of subsequent pregnancies. The efficacy and safety of surgical techniques, according to their transfixing character or not, were analyzed.
  
  
  RESULTS
  Eleven pregnancies after uterine compression suture were reported among 14 women whishing another pregnancy. The median time to be pregnant was 27 months (6-78 months). Nine pregnancies were conducted at term. One case of intrauterine growth restriction and a moderate prematurity at 32 weeks were observed. There was no significant difference in efficacy and early surgical complications according to the surgical technique; however, both infectious and ischemic complications were observed after transfixing compression suture.
  
  
  CONCLUSIONS
  The obstetric prognosis after a uterine compression suture is kept. The transfixing techniques may cause more infectious and ischemic complications. An evaluation of surgical techniques depending on their transfixing, or not, character on a large cohort is necessary for the evaluation of the influence of the technique on fertility and postoperative complications.
authors.affiliation: Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors.forename: C
authors.initials: C
authors.lastname: Loaec
authors.affiliation: Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France. Electronic address: chrisnowak@aliceadsl.fr.
authors.forename: C
authors.initials: C
authors.lastname: Nowak
authors.affiliation: Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors.forename: P
authors.initials: P
authors.lastname: Lopes
authors.affiliation: Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors.forename: N
authors.initials: N
authors.lastname: Winer
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies; D013536:Suture Techniques; D014593:Uterine Inertia; D014599:Uterus / Q000601:surgery*
keywords: C-section; Césarienne; Fertility; Fertilité; Hémorragie de la délivrance; Obstetrical outcome; Plicatures utérines; Postpartum hemorrhage; Pronostic obstétrical; Uterine compression suture