Uterine folding hemostasis: a simpler and safer technique for controlling atonic postpartum hemorrhage

作者：Li, Guang-Tai^*; Li, Guang-Rui; Xu, Hong-Mei; Wu, Bao-Ping; Wang, Xiao-Nian

来源：Archives of Gynecology and Obstetrics, 2016, 294(4): 689-695.

DOI：10.1007/s00404-016-4009-x

• Uterine folding hemostasis
• Postpartum hemorrhage
• Uterine atony
• Uterine compression suture

To observe the efficacy and safety of a uterine folding hemostatic technique in controlling atonic postpartum hemorrhage (PPH) during cesarean delivery.
Thirty-nine women with severe postpartum bleeding from uterine inertia, which did not react to conventional initial management protocols, underwent a uterine folding hemostasis. The procedure was to fold the uterine fundus onto the anterior wall of the corpus uterus using an absorbable suture that thread tautly through the inner myometrial layer of the uterus 1-3 cm below the fundus (not entered into uterine cavity) and 1-2 cm above and below the CS incision (entered into uterine cavity 2-4 cm medal to bilateral border of the uterus).
The technique was sufficient to stanch bleeding immediately in 32 patients (82.1 %). Seven women underwent hypogastric arteries ligation (1 case) or uterine arterial embolization (6 cases) because of continuous bleeding after the procedure. There were no morbidities or abnormalities of the uterus in these 32 patients. Eight women had pregnancies after this hemostasis and the others lacked the desire for future pregnancy.
Uterine folding hemostasis is a simple, safe and effective technique to control the atonic PPH.

• 出版日期2016-10
• 单位煤炭总医院; 中国中医科学院望京医院; 北京丰台医院