A new step-wise surgical technique of knapsack-like uterine compression sutures for intractable postpartum hemorrhage in cesarean section

作者全名："Han, Lei; Zhang, Baolin; Xu, Huishu; Yin, Hongmei; Pang, Yiwei; Zhang, Xianghui; Zhai, Qingliang; Liu, Xiaofeng; Wang, Yanlin; Zhang, Caiying; Xu, Yingjiang; Liu, Yanni; Chen, Xuemei"

作者地址："[Han, Lei; Zhang, Baolin; Xu, Huishu; Yin, Hongmei; Pang, Yiwei; Zhang, Xianghui; Zhai, Qingliang; Liu, Xiaofeng; Wang, Yanlin] Binzhou Med Univ Hosp, Dept Reprod Med, Binzhou 256603, Shandong, Peoples R China; [Han, Lei] Chongqing Med Univ, Affiliated Hosp 3, Dept Obstet & Gynecol, Chongqing, Peoples R China; [Zhang, Baolin] Binzhou Cent Hosp, Dept Obstet & Gynecol, Binzhou 251700, Shandong, Peoples R China; [Yin, Hongmei; Pang, Yiwei; Zhang, Xianghui; Zhai, Qingliang; Liu, Yanni; Chen, Xuemei] Binzhou Med Univ Hosp, Dept Obstet & Gynecol, Binzhou 256603, Shandong, Peoples R China; [Zhang, Caiying] Binzhou Med Univ Hosp, Dept Postgrad Student Off, Binzhou 256603, Shandong, Peoples R China; [Xu, Yingjiang] Binzhou Med Univ Hosp, Dept Intervent Vasc Surg, Binzhou 256603, Shandong, Peoples R China"

通信作者："Han, L (通讯作者)，Binzhou Med Univ Hosp, Dept Reprod Med, Binzhou 256603, Shandong, Peoples R China.; Han, L (通讯作者)，Chongqing Med Univ, Affiliated Hosp 3, Dept Obstet & Gynecol, Chongqing, Peoples R China.; Liu, YN; Chen, XM (通讯作者)，Binzhou Med Univ Hosp, Dept Obstet & Gynecol, Binzhou 256603, Shandong, Peoples R China."

来源：BMC PREGNANCY AND CHILDBIRTH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001135235600018

JCR分区：Q1

影响因子：3.1

年份：2024

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Postpartum hemorrhage; Uterine compression suture; Cesarean section; Uterine atony; Placenta previa; Placenta percreta; Placenta accrete

摘要："BackgroundIntractable postpartum hemorrhage (PPH) during cesarean section has been a significant concern for obstetricians. We aimed to explore the effectiveness and safety of a new type of uterine compression suture, the step-wise surgical technique of knapsack-like sutures for treating intractable PPH caused by uterine atony and placenta factors in cesarean section.MethodsThe step-wise surgical technique of knapsack-like sutures was established on the basis of the artful combination of vertical strap-like sutures and an annular suture-ligation technique. This novel surgical technique was applied to 34 patients diagnosed with PPH during cesarean section due to severe uterine atony and placental factors in our department. The hemostatic effects, clinical outcomes and follow-up visit results were all reviewed and analyzed.ResultsThis new uterine compression suture successfully stopped bleeding in 33 patients, and the effective rate was 97.06%. Only 1 patient failed and was changed to use bilateral uterine arterial embolization and internal iliac artery embolization. The follow-up visits indicated that 33 patients restored menstruation except for 1 who was diagnosed with amenorrhea. The gynecological ultrasound tests of all the patients suggested good uterine involutions, and they had no obvious complaints such as hypogastralgia.ConclusionsThis step-wise surgical technique of knapsack-like uterine compression sutures can compress the uterus completely. It is a technique that can conserve the uterus and fertility function without special equipment in caesarean section for PPH, with the characteristics of being safe, simple and stable (3 S) with rapid surgery, reliable hemostasis and resident doctor to operation (3R)."

基金机构：Scientific Research Fund of Binzhou Medical University

基金资助正文：Not applicable.