Management of Refractory Atonic Post-Partum Hemorrhage by Upper Segment Compression Suture

Abstract

Aims: The study was undertaken to test the efficacy of Upper Segment Compression Suture (USC Suture) for the control of atonic post- partum hemorrhage unresponsive to medical treatment. Study Design: Observational study. Duration: From March 1998 to March 2003. Setting: Department of Obstetrics & Gynaecology, Lahore General Hospital, Post Graduate Medical Institute, Lahore, Pakistan. Subjects: Fourteen women with atomic PPH refractory to medical treatment. Results: Fourteen women with severe atomic PPH were managed using uterine massage and utero tonic drugs. Failing these measures, Upper Segment compression suture was used as first line conservative surgical technique. There was no re-laparotomy for recurrent PPH. All cases were managed successfully avoiding hysterectomy or other complex surgical procedures. Recovery in all cases was uneventful. Long term follow up was available in four cases. All were having normal menstruation Two of them achieved spontaneous pregnancies. Conclusion: Upper Segment Compression Suture is an effective technique for managing refractory PPH caused by uterine atony.