BMC Pregnancy and Childbirth (May 2017)

Is early intervention using Mansoura-VV uterine compression sutures an effective procedure in the management of primary atonic postpartum hemorrhage? : a prospective study

  • Abd Elaziz A. El Refaeey,
  • Hosam Abdelfattah,
  • Alaa Mosbah,
  • Anas M. Gamal,
  • Emad Fayla,
  • Waleed Refaie,
  • Abdelhady Zaied,
  • Rafik I. Barakat,
  • Amal K. Seleem,
  • Mohammed Maher

DOI
https://doi.org/10.1186/s12884-017-1349-x
Journal volume & issue
Vol. 17, no. 1
pp. 1 – 6

Abstract

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Abstract Background Postpartum hemorrhage is the leading cause of maternal death, uterine atony accounts for 75-90% of primary postpartum hemorrhage. The efficacy of the Uterine compression suture in the treatment of atonic postpartum hemorrhage is time-tested and can be said to be almost established.The aim of this study was to assess the role of the Mansoura-VV uterine compression suture as an early intervention in the management of primary atonic postpartum hemorrhage. Methods This prospective observational study included 108 women with primary atonic PPH over a period of 44 months. Uterine atony was diagnosed when the uterus was soft and failed to respond to ordinary ecbolics. Early intervention by Mansoura-VV uterine compression sutures was carried out within 15 min of the second dose of ecobolics and before progressing to any further surgical procedure. Results Following the Mansoura-VV uterine compression sutures, uterine bleeding was controlled in all except one patient (107/108 cases; 99.07%) who required additional bilateral uterine vessels ligation. Another case (0.93%) was subjected to re-laparotomy due to intraperitoneal hemorrhage. Packed RBC transfusion was needed in 10 cases (9.25%). Admission to ICU was needed in 9 cases (8.33%) because of associated medical conditions. One week following the procedure, 1 case (0.93%) was diagnosed with haematometra. Conclusion Early intervention in cases of primary atonic PPH using the Mansoura-VV uterine compression sutures is an easy, rapid and effective method in controlling PPH in low resource settings. Trial registration The study was registered at clinicaltrial.gov , Identifiers: NCT03117647 “retrospectively registererd” registered at April 7, 2017.

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