Uterine cavity synechiae after hemostatic square suturing technique.

BACKGROUND

A number of surgical techniques to control severe bleeding at cesarean delivery have been proposed, such as uterine artery ligation, hypogastric artery ligation, and uterine compression suturing.

CASE

A primigravida with severe postpartum hemorrhage and disseminated intravascular coagulopathy had multiple square sutures placed through the uterus. Serial sonographic follow-up studies revealed uterine synechiae with partial obstruction of menstrual flow. Hysteroscopy confirmed unabsorbed sutures in the uterine cavity.

CONCLUSION

The use of multiple sutures through the uterus is effective to control postpartum hemorrhage but may lead to uterine synechiae.