Simple technique of uterine compression sutures for prevention of primary postpartum hemorrhage during caesarian section

摘要

Objectives: To report our clinical experience of the effect of applying simple technique of uterine compression sutures to prevent primary postpartum hemorrhage in atonic uterus developed during caesarian section. Methodology: The use of simple uterine compression sutures in atonic uterus during caesarian section was reviewed within the period of January 2006 to March 2008 in a tertiary obstetric unit in three Medical College. It is a descriptive observational study. In atony uterus, first to treat fundal compression, used Intravenous or Intramuscular uterotonic drugs followed by per-rectal use of misoprostol and observed 10-15 minutes and then applied simple technique of uterine compression sutures. Results: Age of patients ranged from 15-40 years. 49 patients were primiparae and 54 patients were multiparae. Indications for caesarian section were previous caesarian section 21 (20%), large baby head to disproportion 23 (22%), obstructed labour and prolonged labour 29 (28%), twin pregnancy 16 (15.5%), polyhydromnios 4 (3.8%), abruptio placenta 4 (3.2%), placenta preavia accreta 7 (6.5%), All cases were maintained with post-operative 10 units oxytocin for 8 hours. Two patients needed one unit blood transfusion after surgery. No post-operative excessive bleeding was observed. There was no alteration of uterine involution and lochial discharge. In followed up cases subsequent pregnancy were 12(11.6%). Conclusion: Extreme degree of uterine compression may leads to uterine anatomic damage. Simple compression technique is surgically easy, with life saving potential, offers relative safety, time saving and can be managed by trainee doctors after some experience.