Uterine Cavity Synechiae After Hemostatic Square Suturing Technique

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 105; no. 5, Part 2 Suppl; pp. 1176 - 1178
• Main Authors: Wu, Hsin-hung, Yeh, Guang-Perng
• Format: Journal Article
• Language: English
• Published: New York, NY The American College of Obstetricians and Gynecologists 01.05.2005; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Cesarean Section - adverse effects; Cesarean Section - methods; Female; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Hemostasis, Surgical - adverse effects; Hemostasis, Surgical - methods; Humans; Hysteroscopy - methods; Medical sciences; Postpartum Hemorrhage - diagnosis; Postpartum Hemorrhage - surgery; Pregnancy; Reoperation; Risk Assessment; Suture Techniques - adverse effects; Sutures - adverse effects; Tissue Adhesions - diagnosis; Tissue Adhesions - surgery; Treatment Outcome; Ultrasonography, Doppler; Cavity; Hemostatic; Uterus; Hemostasis; Gynecology; Female genital system; Technique; Obstetrics
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/01.AOG.0000159978.26472.a4

BACKGROUND:A number of surgical techniques to control severe bleeding at cesarean delivery have been proposed, such as uterine artery ligation, hypogastric artery ligation, and uterine compression suturing. CASE:A primigravida with severe postpartum hemorrhage and disseminated intravascular coagulopathy had multiple square sutures placed through the uterus. Serial sonographic follow-up studies revealed uterine synechiae with partial obstruction of menstrual flow. Hysteroscopy confirmed unabsorbed sutures in the uterine cavity. CONCLUSION:The use of multiple sutures through the uterus is effective to control postpartum hemorrhage but may lead to uterine synechiae.