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

• Main Authors: Abd Elaziz A. El Refaeey (Author), Hosam Abdelfattah (Author), Alaa Mosbah (Author), Anas M. Gamal (Author), Emad Fayla (Author), Waleed Refaie (Author), Abdelhady Zaied (Author), Rafik I. Barakat (Author), Amal K. Seleem (Author), Mohammed Maher (Author)
• Format: Book
• Published: BMC, 2017-05-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/s12884-017-1349-x; 1471-2393
• Keywords: Atonic postpartum hemorrhage; Uterine compression sutures; Gynecology and obstetrics; RG1-991
• Source: BMC Pregnancy and Childbirth, Vol 17, Iss 1, Pp 1-6 (2017)

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.