Uterine compression sutures for preserving fertility in severe postpartum haemorrhage: An overview 13 years after the first description

Abstract

We performed a systematic review of the current literature on efficacy, complications and impact on future pregnancies of uterine compression sutures (UCS) applied in cases of severe postpartum haemorrhage (PPH) in women who wish to preserve fertility. Publications related to UCS from their initial description 03/1996–07/2009, were identified using PubMed and EMBASE. Numerous case series have demonstrated the high efficiency of UCS against PPH. When performed correctly, they are associated with a low complications rate. A higher risk of uterine ischaemia seems to be caused when combined with vessel ligation. No negative impact on fertility has been reported. Uncomplicated future pregnancies occur within a range of 1–3 years. UCS appear safe, simple to learn and preserve future reproductive potential. They should be considered prior to definite measures like hysterectomy in severe PPH. Long-term follow-up is recommended when additional combined vessel ligation is performed due to the potential risk of ischaemic necrosis.

Keywords:

• B-Lynch
• embolisation
• hysterectomy
• postpartum haemorrhage
• uterine atony
• uterine compression sutures
• vessel ligation

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.