Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, and the Department of Obstetrics and Gynecology, Faculty of Medicine, College of Health Sciences, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria.
Obstet Gynecol. 2020 Sep;136(3):466-469. doi: 10.1097/AOG.0000000000003947.
Postpartum hemorrhage is a leading cause of maternal morbidity and mortality worldwide, with uterine atony responsible in 80% of cases. In intractable cases, hysterectomy is the final treatment, but it has complications. Many doctors in developing countries with high maternal mortality rates from postpartum hemorrhage can perform cesarean deliveries but cannot perform hysterectomy. Patients with postpartum hemorrhage who need hysterectomy in these countries will die in such cases, whereas, if doctors know this simple, easily learned technique, such patients may survive.
Esike's technique is a uterine-compression method that uses supplies generally available at delivery hospitals. Six sutures are placed in the lower uterine segment, three anteriorly and three posteriorly. Starting with the middle sutures, the sutures are tied at the fundus with the help of an assistant to provide uterine compression. The more laterally placed sutures are then tied similarly, resulting in uterine compression and stoppage of postpartum hemorrhage.
Esike's technique was used in controlling life-threatening, uncontrollable postpartum hemorrhage in 18 women and was successful in 16 (89%) without requiring hysterectomy.
Esike's technique is effective in controlling life-threatening postpartum hemorrhage and can be used in low-resource settings with commonly available supplies and performed by doctors with a common level of training.
产后出血是全球孕产妇发病率和死亡率的主要原因，其中 80%的病例由子宫收缩乏力引起。在难治性病例中，子宫切除术是最终的治疗方法，但它有并发症。许多发展中国家的医生能够进行剖宫产，但不能进行子宫切除术。在这些国家，需要进行子宫切除术的产后出血患者将在这种情况下死亡，而如果医生了解这种简单、易于学习的技术，这些患者可能会存活下来。
Esike 技术是一种子宫压迫方法，使用分娩医院通常提供的用品。在下子宫段放置 6 条缝线，前 3 条，后 3 条。从中间缝线开始，在助手的帮助下在子宫底系紧缝线，以提供子宫压迫。然后类似地系紧更靠外侧的缝线，从而压迫子宫并停止产后出血。
Esike 技术用于控制危及生命的、无法控制的产后出血 18 例，其中 16 例（89%）成功，无需进行子宫切除术。
Esike 技术在控制危及生命的产后出血方面是有效的，可以在资源有限的环境中使用常用的用品，并由接受过普通培训的医生进行。
