Multiple square sutures for postpartum hemorrhage: results and hysteroscopic assessment - 01/10/11
, Sekou Coly, MD, Pascal Mégier, MD, Bruno Lemaire, MD, Louis Mesnard, MD, Alain Desroches, MD
Reprints: Souhail Alouini, MD, PhD, Regional Hospital Center of Orléans, Obstetrics and Gynecology, 1 porte Madeleine, Orléans 45000, FranceRésumé |
Objective |
The purpose of this study was to evaluate the efficiency and morbidity of multiple square sutures in severe postpartum hemorrhage.
Study Design |
A retrospective study encompassed 30 multiple square sutures that were performed for severe postpartum hemorrhage in 26,605 deliveries in a tertiary maternity center. The main outcome measures were the ability to stop hemorrhage and the assessment of the uterine cavity by hysteroscopy at 3 months.
Results |
Multiple square sutures stopped postpartum hemorrhage in 28 of 30 cases (93%). Twenty women underwent hysteroscopy after multiple square sutures. Eight women (40%) did not have intrauterine adhesions. Nine women (45%) had thin and localized intrauterine adhesions that were removed easily by the tip of the hysteroscope; 2 women had moderate intrauterine adhesions that were resected. One patient had endometritis followed by severe intrauterine adhesions.
Conclusion |
Multiple square sutures are effective and safe for the control of severe postpartum hemorrhage and for uterine conservation in most cases. Although some patients had moderate or severe adhesions, a normal uterine cavity or minimal intrauterine adhesions that were removed easily were the most frequent findings at hysteroscopy. A prospective study may be helpful to compare the safety and efficiency of square and brace sutures.
Le texte complet de cet article est disponible en PDF.Key words : fertility, hysteroscopy, intrauterine adhesion, multiple square sutures, postpartum hemorrhage, uterine conservation
Plan
| Cite this article as: Alouini S, Coly S, Mégier P, et al. Multiple square sutures for postpartum hemorrhage: results and hysteroscopic assessment. Am J Obstet Gynecol 2011;205:335.e1-6. |
Vol 205 - N° 4
P. 335.e1-335.e6 - octobre 2011 Retour au numéro
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