Hemostatic suturing technique for uterine bleeding during cesarean delivery

Background: If medical management is unsuccessful in controlling postpartum hemorrhage, conservative surgical intervention or cesarean hysterectomy is required. Technique: Hemostatic multiple square suturing using a straight number 7 or number 8 needle and number 1 chromic catgut is a new surgical technique to approximate anterior and posterior uterine walls, especially in areas wher e there is heavy bleeding. It controls postpartum hemorrhage by attachment and compression of the hemorrhage site of the endometrium or myometrium. Experience: We used this technique in 23 women with postpartum hemorrhages at cesarean who did not respond to conservative treatment. In all 23 cases, bleeding decreased markedly and hysterectomy was avoided. All resumed norm al menstrual flow after surgery. In four cases, further pregnancy was achie ved after this method was used. Conclusion: Hemostatic multiple square suturing is an easy, safe, conservat ive surgical alternative to hysterectomy for treating uncontrollable postpa rtum hemorrhage. (Obstet Gynecol 2000;96:129-31. (C) 2000 by The American C ollege of Obstetricians and Gynecologists.).