A new uterine suture technique to control PPH in congenitally malformed uterus during caesarean section

Summary

The objective of this prospective study was to evaluate the efficacy of simultaneous devascularisation and compression suture for the control of PPH in a congenitally malformed uterus during caesarean section while classic management failed. The technique adopted for devascularisation was ligation of uterine arteries bilaterally below the hysterotomy wound and for the compression of the uterine musculature, suture passing through and through the anterior and posterior wall above the hysterotomy wound closed to either side, tied anteriorly. The majority (75%) of the women were primigravida and mostly presented with malpresentation of the fetus. Mothers were in the age group of 19–24 years. Out of eight cases, four (50%) cases had a bicornuate uterus, two cases had unicornuate and two had a sub-septate uterus. This procedure was effective in 87.5% (7/8) of cases. In follow-up, normal puerperium, menstruation and pregnancy were observed. This procedure is a simple, effective and safe technique to control PPH in congenitally malformed uterus in the field of conservative surgical approaches.

Keywords:

• Malformation
• PPH
• uterine artery ligation