[Risk of uterine synechiae following uterine compression sutures during postpartum haemorrhage].

Abstract

OBJECTIVES:

Uterine compression sutures are highly successful conservative surgical techniques used to treat severe postpartum haemorrhage. These methods can induce subsequent uterine synechiae. To determine this risk of synechiae after conservative uterine compression sutures, which may induce further fertility problems.

PATIENTS AND METHODS:

We retrospectively reviewed the medical and pathological records of the patients who underwent uterine compression sutures for severe postpartum haemorrhage between January 2003 and March 2013 in a French University Hospital. The Cho's, the B-Lynch's and the Hayman's techniques have been used. The results of the hysteroscopies were detailed.

RESULTS:

Among the 25 patients included, the B-Lynch or the Hayman's techniques have been used in 13 cases (52%). The Cho's technique has been performed alone for 5 patients (20%) and both techniques have been practiced in 7 situations (28%). In 17 cases (68%), some vascular sutures have been associated and, for 7 patients (28%), a vascular embolisation had been performed before the uterine compressive sutures. Only 19 patients underwent a diagnostic hysteroscopy and among them 13 had a normal uterine cavity (68%), 3 of them had uterine synechiae (16%) and 3 had placental retention (16%). Synechiae and retention have all been successfully removed by operative hysteroscopy.

DISCUSSION AND CONCLUSION:

The compressive techniques can induce uterine synechiae, which may impair subsequent fertility.

• Authors: A Jamard, M Turck, A Chéret-Benoist, M Dreyfus, G Benoist
• Journal: Gynecologie, obstetrique & fertilite (Gynecol Obstet Fertil) Vol. 42 Issue 10 Pg. 681-5 (Oct 2014) ISSN: 1769-6682 [Electronic] France
• Vernacular Title: Risque de synéchie utérine après capitonnage utérin pour hémorragie du post-partum.
• PMID: 24996879 (Publication Type: English Abstract, Journal Article)
• Copyright: Copyright © 2014. Published by Elsevier SAS.

Topics

• Adult
• Female
• Gynatresia (epidemiology, etiology, surgery)
• Humans
• Hysteroscopy
• Obstetric Surgical Procedures (methods)
• Placenta, Retained (epidemiology, surgery)
• Postpartum Hemorrhage (surgery)
• Pregnancy
• Retrospective Studies
• Risk Factors
• Suture Techniques (adverse effects)