Efficacy of Different Uterine Compression Sutures in Controlling Excessive Uterine Bleeding during Caesarean Section

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Ain Shams University Maternity Hospital Cairo, Egypt

2 Department of Obstetrics & Gynecology, New Cairo Hospital, Cairo, Egypt

3 Department of Obstetrics and Gynecology, Ain Shams University Maternity Hospital Cairo, Egypt.

Abstract

Introduction: Obstetric hemorrhage remains the leading cause of maternal mortality in both developed and developing countries. Postpartum hemorrhage is blood loss more than 500 ml in vaginal delivery and more than 1000 ml within 24 h in cesarean section. The objective of this study is to compare the safety and efficacy of Nausicaa and B-Lynch compressive sutures to control excessive uterine bleeding during cesarean section. 
Methods: The study included 60 women suffering from excessive uterine bleeding during cesarean section in Ain Shams University Maternity Hospital, a tertiary referral center in Cairo, Egypt with annual rate of seven thousand cesarean sections per year Participants were randomly assigned to Nausicaa suture and B-Lynch suture done. The primary outcome was emergency hysterectomy.
Results : Nausicaa suture achieved hemostasis and prevented hysterectomy in 80% of allocated patients compared to 96.7% in B-Lynch suture. B-Lynch suture required shorter procedure time (7.2 ±3.3 vs16.1 ±4.9, 95% CI 6.8-11.2, p<0.001) compared to Nausicaa suture, with less blood loss in B Lynch suture (1473.3±429.9 ml vs1886.7±620.2 ml, 95% CI (6.8–11.1, p<0.001) compared to Nausicaa suture.
Conclusion: B-Lynch suture is more effective than Nausicca suture in controlling excessive uterine bleeding and preventing emergency hysterectomy during cesarean section. 

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