Serviço de Ginecologia e Obstetrícia. Hospital Garcia de Orta. Almada. Portugal.
Acta Med Port. 2024 Jul 1;37(7-8):518-525. doi: 10.20344/amp.20429.
Uterine compressive sutures are conservative measures applied in cases of severe postpartum hemorrhage unresponsive to uterotonics. Pereira's suture was introduced in 2005 and consists of two longitudinal and three transverse non-transfixes sutures. Previous studies reported favorable results, highlighting its benefits and value. The aim of this study was to assess the efficacy, complications, and impact on fertility and future pregnancies of Pereira's suture applied in cases of uterine atony and postpartum hemorrhage.
An observational retrospective study was performed by consulting the medical records of women treated with Pereira's compressive sutures in a tertiary center between January 2013 and December 2022. We registered demographic data, pregnancy outcomes, short-term complications, and outcomes of subsequent pregnancies.
A total of 50 women were treated with Pereira's suture. The overall success rate was 96% and no hysterectomies were performed. Women who had sutures performed during an intra-cesarean section had better outcomes than those who had an after-cesarean section. Complications were reported in 12% (n = 6) of women, with the most frequent being pelvic infection (n = 3) and abdominal pain (n = 3). Regarding fertility, all women desiring a future pregnancy (n = 5) were able to conceive, resulting in three live births.
Pereira's suture is a type of suture that provides numerous advantages and should be considered when first-line medical treatment fails. When applied at an early stage, the sutures may prevent maternal morbidity. The Alcides Pereira's suture is a safe technique and appears to preserve fertility.
子宫压迫缝合术是一种保守治疗方法，适用于对宫缩剂无反应的严重产后出血病例。佩雷拉缝合术于 2005 年引入，由两条纵向和三条横向非贯穿缝线组成。先前的研究报告了良好的结果，强调了其益处和价值。本研究旨在评估佩雷拉缝合术在宫缩乏力和产后出血病例中的疗效、并发症以及对生育和未来妊娠的影响。
通过查阅 2013 年 1 月至 2022 年 12 月在一家三级中心接受佩雷拉压迫缝合术治疗的女性的病历，进行了一项观察性回顾性研究。我们登记了人口统计学数据、妊娠结局、短期并发症以及后续妊娠的结局。
共有 50 名女性接受了佩雷拉缝合术治疗。总体成功率为 96%，未行子宫切除术。在剖宫产术中进行缝合的女性比在剖宫产术后进行缝合的女性结局更好。12%（n=6）的女性报告了并发症，最常见的是盆腔感染（n=3）和腹痛（n=3）。关于生育能力，所有希望未来怀孕的女性（n=5）都能够怀孕，其中 3 人分娩活产。
佩雷拉缝合术是一种提供多种优势的缝合术，如果一线治疗失败，应考虑使用。当早期应用时，缝合术可能会预防产妇发病率。阿尔西德斯·佩雷拉缝合术是一种安全的技术，似乎能保留生育能力。
