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Cordeiro Féria B, Nazaré P, Figueiredo J, Neves Gomes I, Pereira A. Efficacy, Complications and Effects of Alcides Pereira's Sutures in the Management of Uterine Atony: A Retrospective Study. ACTA MEDICA PORT 2024. [PMID: 38447018 DOI: 10.20344/amp.20429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/08/2023] [Indexed: 03/08/2024]
Abstract
INTRODUCTION 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. METHODS 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. RESULTS 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. CONCLUSION 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.
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Affiliation(s)
| | - Patrícia Nazaré
- Serviço de Ginecologia e Obstetrícia. Hospital Garcia de Orta. Almada. Portugal
| | - Joana Figueiredo
- Serviço de Ginecologia e Obstetrícia. Hospital Garcia de Orta. Almada. Portugal
| | - Inês Neves Gomes
- Serviço de Ginecologia e Obstetrícia. Hospital Garcia de Orta. Almada. Portugal
| | - Alcides Pereira
- Serviço de Ginecologia e Obstetrícia. Hospital Garcia de Orta. Almada. Portugal
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Bouchghoul H, Madar H, Resch B, Pineles BL, Mattuizzi A, Froeliger A, Sentilhes L. Uterine-sparing surgical procedures to control postpartum hemorrhage. Am J Obstet Gynecol 2024; 230:S1066-S1075.e4. [PMID: 37729440 DOI: 10.1016/j.ajog.2022.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/05/2022] [Accepted: 06/12/2022] [Indexed: 09/22/2023]
Abstract
Postpartum hemorrhage remains one of the principal causes of maternal mortality in the United States and throughout the world. Its management, which must be multidisciplinary (obstetrics, midwifery, anesthesiology, interventional radiology, and nursing), depends on the speed of both diagnosis and implementation of medical and surgical treatment to control the hemorrhage. The aim of this work is to describe the various techniques of vessel ligation and of uterine compression for controlling and treating severe hemorrhage, and to present the advantages and disadvantages of each. It is not difficult to perform vessel ligation of the uterine arteries: O'Leary's bilateral ligation of the uterine artery, Tsirulnikov's triple ligation, and AbdRabbo's stepwise uterine devascularization (that is, stepwise triple ligation). These procedures are associated with a high success rate (approximately 90%) and a low complication rate. Bilateral ligation of the internal iliac (hypogastric) arteries is more difficult to perform and potentially less effective (approximately 70% effectiveness) than the previously mentioned procedures. Its complication rate is low, but the complications are most often serious. There is no evidence that future fertility or subsequent obstetrical outcomes are impaired by ligation of either the uterine or internal iliac arteries. There are many techniques used for uterine compression sutures, and none has shown clear superiority to another. Uterine compression suture has an effectiveness rate of approximately 75% after failure of medical treatment and approximately 80% as a second-line procedure after unsuccessful vessel ligation. The risk of synechiae after uterine compression suture has not yet been adequately evaluated, but is probably around 5%. The risk of synechiae after uterine compression suture has not yet been adequately evaluated, but probably ranges between 5% and 10%. The methodologic quality of the studies assessing uterine-sparing surgical procedures remains limited, with no comparative studies. Accordingly, no evidence suggests that any one of these methods is better than any other. Accordingly, the choice of surgical technique to control hemorrhage must be guided firstly by the operator's experience. If the hemorrhage continues after a first-line uterine-sparing surgical procedure and the patient remains hemodynamically stable, a second-line procedure can be chosen. Nonetheless, the application of these procedures must not delay the performance of a peripartum hysterectomy in cases of hemodynamic instability.
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Affiliation(s)
- Hanane Bouchghoul
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France
| | - Hugo Madar
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France
| | - Benoit Resch
- Department of Obstetrics and Gynecology, Rouen University Hospital, Rouen, France; Department of Gynecologic Surgery, Clinique Mathilde, Rouen, France
| | - Beth L Pineles
- Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center, Houston, TX
| | - Aurélien Mattuizzi
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France
| | - Alizée Froeliger
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France
| | - Loïc Sentilhes
- Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France.
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Subbaiah M, Chaturvedula L, Kubera NS, Raj A. Subsequent pregnancy outcome after uterine compression suture placement for postpartum hemorrhage. Int J Gynaecol Obstet 2021; 156:475-480. [PMID: 33864681 DOI: 10.1002/ijgo.13710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/07/2021] [Accepted: 04/13/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the subsequent obstetrical outcome in women who received a uterine compression suture. METHODS This is a retrospective cohort study of women who received a uterine compression suture for postpartum hemorrhage (PPH) between January 2009 and December 2018 and had a subsequent pregnancy at a tertiary care hospital in India. Women who had PPH but did not receive uterine compression sutures and had a subsequent pregnancy were taken as controls. RESULTS Sixty-two women had a subsequent pregnancy after uterine compression suture and were included in this study. There were no significant differences in the subsequent pregnancy outcome between the study and control groups. However, women with a history of uterine compression suture were found to have a higher incidence of dense omental adhesions (15% versus 2.8%; P < 0.001), more intrapartum blood loss (740.5 ± 491.8 ml versus 638.8 ± 194 ml; P = 0.02), and were more likely to need repeat uterine compression suture (6.7% versus 0%; P = 0.004). CONCLUSION Women who received uterine compression sutures had similar obstetrical outcomes in their subsequent pregnancy compared with those who did not receive a suture for PPH management. However, they had a higher risk of dense omental adhesions, repeat uterine compression suture application, and intrapartum blood loss.
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Affiliation(s)
- Murali Subbaiah
- Department of Obstetrics and Gynecology, JIPMER, Pondicherry, India
| | | | | | - Ashwini Raj
- Department of Obstetrics and Gynecology, JIPMER, Pondicherry, India
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Li GT, Li XF, Li GR, Wu BP, Zhang XL, Xu HM. Removable retropubic uterine compression suture for controlling postpartum hemorrhage. J Obstet Gynaecol Res 2021; 47:1337-1343. [PMID: 33590596 DOI: 10.1111/jog.14698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 01/14/2021] [Accepted: 01/29/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To minimize the adverse events of uterine compression suture in controlling postpartum hemorrhage (PPH) and to search for a prophylactic approach to potential PPH. METHODS A retrospective analysis was performed in 39 women with removable retropubic uterine compression suture (RRUCS) to stop PPH due to uterine atony during cesarean section (CS). The procedure was to suspend and compress the uterus to the retropubic abdominal wall using an absorbable suture. RESULTS The technique was sufficient to stanch bleeding immediately in 36 patients (92.31%, 36/39). No morbidity or abnormalities occurred in women who underwent RRUCS. Subsequent pregnancies occurred in 10 cases, but the others lacked the desire for future pregnancy. CONCLUSION RRUCS is a simple, safe, and effective technique in controlling atonic PPH; it is also used as a prophylactic application in patients with potential PPH after CS.
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Affiliation(s)
- Guang-Tai Li
- Department of Obstetrics and Gynecology, Hebei Yanda Hospital, affiliated to Hebei Medical University, Beijing, China.,Department of Obstetrics and Gynecology, China Meitan General Hospital (Emergency General Hospital), Beijing, China
| | - Xiao-Fan Li
- Department of Radiation Oncology, Peking University School of Oncology, Peking University Cancer Hospital, Beijing, China
| | - Guang-Rui Li
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Bao-Ping Wu
- Department of Obstetrics and Gynecology, China Meitan General Hospital (Emergency General Hospital), Beijing, China
| | - Xiu-Lan Zhang
- Department of Obstetrics and Gynecology, Sanya City Womenfolk and Infant Health Care Hospital, Sanya City, China
| | - Hong-Mei Xu
- Department of Obstetrics and Gynecology, Beijing Fengtai Hospital, affiliated Capital Medical University, Beijing, China
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Egashira K, Hiasa K, Yokota N, Kawamura T, Matsushita T, Okugawa K, Yahata H, Sonoda K, Kato K. Infertility after abdominal trachelectomy. Acta Obstet Gynecol Scand 2018; 97:1358-1364. [DOI: 10.1111/aogs.13429] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 07/03/2018] [Accepted: 07/10/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Katsuko Egashira
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Kana Hiasa
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Natsuko Yokota
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Teruhiko Kawamura
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Tomoko Matsushita
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Kaoru Okugawa
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Hideaki Yahata
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Kenzo Sonoda
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Kiyoko Kato
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
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Li GT, Li XF, Zhang YH, Si Y, Li GR, Xu HM. Ring compression suture for controlling post-partum hemorrhage during cesarean section. J Obstet Gynaecol Res 2018; 44:1424-1430. [PMID: 29744974 DOI: 10.1111/jog.13676] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 04/08/2018] [Indexed: 11/29/2022]
Abstract
AIM To avoid complications associated with uterine compression sutures, we devised a ring compression suture (RCS). METHODS The RCS was performed on 12 patients with post-partum hemorrhage (PPH) during cesarean section. The suture was inserted 0.5 cm below the attachment point of the uterosacral ligament into the uterine cavity and pushed downward through the cervical canal into the vagina. The other end of the stitch was threaded through the lower abdominal wall, from the inside of the abdomen cavity to the outside of the abdominal wall, emerging at the external surface of the lower abdomen 2 cm lateral to the ventral median line and 1 cm above the symphysis pubis. Then, the two ends of the suture (the end in the vagina had been pulled out in advance) were tied tightly on the pudendum. The same stitch was repeated on the contralateral side. After 48 h postoperatively, the suture was removed through the vagina under sterilization. RESULTS All 12 women with PPH who underwent RCS achieved hemostasis, and complications related to RCS were not seen. Two of them had successful pregnancies postoperatively. The remaining women had no desire for a further pregnancy. CONCLUSION The procedure can be used as an alternative to peripartum hysterectomy and also as a prophylactic application in PPH.
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Affiliation(s)
- Guang-Tai Li
- Department of Obstetrics and Gynecology, China Meitan General Hospital, Beijing, China
| | - Xiao-Fan Li
- Department of Radiation Oncology, Peking University School of Oncology, Peking University Cancer Hospital, Beijing, China
| | - Yun-He Zhang
- Department of Obstetrics and Gynecology, China Meitan General Hospital, Beijing, China
| | - Yue Si
- Department of Obstetrics and Gynecology, China Meitan General Hospital, Beijing, China.,Department of Obstetrics and Gynecology, Beijing Fengtai Hospital, Affiliated Capital Medical University, Beijing, China
| | - Guang-Rui Li
- China Academy of Chinese Medical Sciences, Wangjing Hospital, Beijing, China
| | - Hong-Mei Xu
- Department of Obstetrics and Gynecology, Beijing Fengtai Hospital, Affiliated Capital Medical University, Beijing, China
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Rani PR, Begum J. Recent Advances in the Management of Major Postpartum Haemorrhage - A Review. J Clin Diagn Res 2017; 11:QE01-QE05. [PMID: 28384942 DOI: 10.7860/jcdr/2017/22659.9463] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 10/25/2016] [Indexed: 11/24/2022]
Abstract
Postpartum haemorrhage (PPH) is a leading cause of maternal mortality and morbidity worldwide and 75-90% of these haemorrhage results from uterine atony. Delayed and substandard obstetrics care can kill a woman within hours of Major Obstetric Haemorrhage (MOH). Prenatal identification of at risk women, prompt assessment of blood loss, effective management and involvement of multidisciplinary teams is of utmost importance to save the lives of these women. However, even with the best prenatal care, PPH occurs, it can occur without any risk factors. The first step in management is achieving haemodynamic stability, second being arrest of bleeding, both are done simultaneously. Cases of refractory PPH is managed by postpartum hysterectomy which results in complete inability in hosting a future pregnancy, a psychological impact and risk of intra operative surgical morbidities. This review discusses the current evidence based management of PPH, existing controversies in transfusion of blood and blood products and newer advances in this field. It was conducted by searching the English language medical literature using Medline (1994-2015). The current scenario in developing countries mandates research on newer and practicable strategies to tackle PPH which can be implemented effectively and have an upper edge over the existing practices in the management of PPH.
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Affiliation(s)
- P Reddi Rani
- Professor, Department of Obstetrics and Gynaecology, Mahatama Gandhi Medical College and Research , Pillaiyarkuppam, Puducherry, India
| | - Jasmina Begum
- Associate Professor, Department of Obstetrics and Gynaecology, Mahatama Gandhi Medical College and Research , Pillaiyarkuppam, Puducherry, India
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Yüksel H. A novel approach to primary lower uterine segment atony. Taiwan J Obstet Gynecol 2015; 54:452-4. [PMID: 26384071 DOI: 10.1016/j.tjog.2014.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2014] [Indexed: 10/23/2022] Open
Affiliation(s)
- Hasan Yüksel
- Adnan Menderes University, Faculty of Medicine, Department of Obstetrics and Gynecology, Aydın, Turkey.
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Martin E, Legendre G, Bouet PE, Cheve MT, Multon O, Sentilhes L. Maternal outcomes after uterine balloon tamponade for postpartum hemorrhage. Acta Obstet Gynecol Scand 2015; 94:399-404. [DOI: 10.1111/aogs.12591] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 01/15/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Emmanuelle Martin
- Department of Obstetrics and Gynecology; Angers University Hospital; Angers France
| | - Guillaume Legendre
- Department of Obstetrics and Gynecology; Angers University Hospital; Angers France
| | | | - Marie-Therese Cheve
- Department of Obstetrics and Gynecology; Le Mans General Hospital; Le Mans France
| | - Olivier Multon
- Department of Obstetrics and Gynecology; Atlantic Polyclinic; Saint-Herblain France
| | - Loïc Sentilhes
- Department of Obstetrics and Gynecology; Angers University Hospital; Angers France
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Haumonté JB, Sentilhes L, Macé P, Cravello L, Boubli L, d’Ercole C. Prise en charge chirurgicale d’une hémorragie du post-partum. ACTA ACUST UNITED AC 2014; 43:1083-103. [DOI: 10.1016/j.jgyn.2014.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Jamard A, Turck M, Chéret-Benoist A, Dreyfus M, Benoist G. [Risk of uterine synechiae following uterine compression sutures during postpartum haemorrhage]. ACTA ACUST UNITED AC 2014; 42:681-5. [PMID: 24996879 DOI: 10.1016/j.gyobfe.2014.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 04/28/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Uterine compression sutures are highly successful conservative surgical techniques used to treat severe postpartum haemorrhage. These methods can induce subsequent uterine synechiae. To determine this risk of synechiae after conservative uterine compression sutures, which may induce further fertility problems. PATIENTS AND METHODS We retrospectively reviewed the medical and pathological records of the patients who underwent uterine compression sutures for severe postpartum haemorrhage between January 2003 and March 2013 in a French University Hospital. The Cho's, the B-Lynch's and the Hayman's techniques have been used. The results of the hysteroscopies were detailed. RESULTS Among the 25 patients included, the B-Lynch or the Hayman's techniques have been used in 13 cases (52%). The Cho's technique has been performed alone for 5 patients (20%) and both techniques have been practiced in 7 situations (28%). In 17 cases (68%), some vascular sutures have been associated and, for 7 patients (28%), a vascular embolisation had been performed before the uterine compressive sutures. Only 19 patients underwent a diagnostic hysteroscopy and among them 13 had a normal uterine cavity (68%), 3 of them had uterine synechiae (16%) and 3 had placental retention (16%). Synechiae and retention have all been successfully removed by operative hysteroscopy. DISCUSSION AND CONCLUSION The compressive techniques can induce uterine synechiae, which may impair subsequent fertility.
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Affiliation(s)
- A Jamard
- Département d'obstétrique, de gynécologie et de médecine de la reproduction, pôle femmes-enfants, CHU de Caen, avenue de la Côte-de-Nacre, 14000 Caen, France; Université de Caen - Basse-Normandie, 14000 Caen, France
| | - M Turck
- Département d'obstétrique, de gynécologie et de médecine de la reproduction, pôle femmes-enfants, CHU de Caen, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - A Chéret-Benoist
- Département d'obstétrique, de gynécologie et de médecine de la reproduction, pôle femmes-enfants, CHU de Caen, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - M Dreyfus
- Département d'obstétrique, de gynécologie et de médecine de la reproduction, pôle femmes-enfants, CHU de Caen, avenue de la Côte-de-Nacre, 14000 Caen, France; Université de Caen - Basse-Normandie, 14000 Caen, France
| | - G Benoist
- Département d'obstétrique, de gynécologie et de médecine de la reproduction, pôle femmes-enfants, CHU de Caen, avenue de la Côte-de-Nacre, 14000 Caen, France; Université de Caen - Basse-Normandie, 14000 Caen, France.
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Yan JY, Zhou ZM, Xu X, Huang XY, Xu RL, Lin SH. Risk factors and surgical interventions associated with primary postpartum haemorrhage unresponsive to first-line therapies. J OBSTET GYNAECOL 2014; 34:588-92. [DOI: 10.3109/01443615.2014.920310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Later reproductive health after B-Lynch sutures: a follow-up study after 10 years' clinical use of the B-Lynch suture. Fertil Steril 2014; 101:1194-9. [DOI: 10.1016/j.fertnstert.2014.01.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 12/23/2013] [Accepted: 01/10/2014] [Indexed: 11/18/2022]
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Matsubara S, Yano H, Ohkuchi A, Kuwata T, Usui R, Suzuki M. Uterine compression sutures for postpartum hemorrhage: an overview. Acta Obstet Gynecol Scand 2013; 92:378-85. [DOI: 10.1111/aogs.12077] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 01/07/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Shigeki Matsubara
- Department of Obstetrics and Gynecology; Jichi Medical University; Tochigi; Japan
| | - Hitoshi Yano
- Department of Obstetrics and Gynecology; Jichi Medical University; Tochigi; Japan
| | - Akihide Ohkuchi
- Department of Obstetrics and Gynecology; Jichi Medical University; Tochigi; Japan
| | - Tomoyuki Kuwata
- Department of Obstetrics and Gynecology; Jichi Medical University; Tochigi; Japan
| | - Rie Usui
- Department of Obstetrics and Gynecology; Jichi Medical University; Tochigi; Japan
| | - Mitsuaki Suzuki
- Department of Obstetrics and Gynecology; Jichi Medical University; Tochigi; Japan
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Rath W, Hackethal A, Bohlmann MK. Second-line treatment of postpartum haemorrhage (PPH). Arch Gynecol Obstet 2012; 286:549-61. [DOI: 10.1007/s00404-012-2329-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 04/10/2012] [Indexed: 10/28/2022]
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