Uterine compression sutures for management of severe postpartum haemorrhage: five-year audit.

OBJECTIVES: To audit the use of compression sutures for the management of massive postpartum haemorrhage and compare outcomes to those documented in the literature.

DESIGN: Retrospective study.

SETTING: A regional obstetric unit in Hong Kong.

PATIENTS: Patients with severe postpartum haemorrhage encountered over a 5-year period from January 2008 to December 2012, in which compression sutures were used for management.

MAIN OUTCOME MEASURES: Successful management with prevention of hysterectomy.

RESULTS: In all, 35 patients with massive postpartum haemorrhage with failed medical treatment, for whom compression sutures were used in the management, were identified. The overall success rate for the use of B-Lynch compression sutures alone to prevent hysterectomy was 23/35 (66%), and the success rate of compression sutures in conjunction with other surgical procedures was 26/35 (74%). This reported success rate appeared lower than that reported in the literature.

CONCLUSION: Uterine compression was an effective method for the management of massive postpartum haemorrhage in approximately 70% of cases, and could be used in conjunction with other interventions to increase its success rate in terms of avoiding hysterectomy.