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Uterine folding hemostasis: a simpler and safer technique for controlling atonic postpartum hemorrhage

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To observe the efficacy and safety of a uterine folding hemostatic technique in controlling atonic postpartum hemorrhage (PPH) during cesarean delivery.

Methods

Thirty-nine women with severe postpartum bleeding from uterine inertia, which did not react to conventional initial management protocols, underwent a uterine folding hemostasis. The procedure was to fold the uterine fundus onto the anterior wall of the corpus uterus using an absorbable suture that thread tautly through the inner myometrial layer of the uterus 1–3 cm below the fundus (not entered into uterine cavity) and 1–2 cm above and below the CS incision (entered into uterine cavity 2–4 cm medal to bilateral border of the uterus).

Results

The technique was sufficient to stanch bleeding immediately in 32 patients (82.1 %). Seven women underwent hypogastric arteries ligation (1 case) or uterine arterial embolization (6 cases) because of continuous bleeding after the procedure. There were no morbidities or abnormalities of the uterus in these 32 patients. Eight women had pregnancies after this hemostasis and the others lacked the desire for future pregnancy.

Conclusion

Uterine folding hemostasis is a simple, safe and effective technique to control the atonic PPH.

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Authors’ contributions

GT Li conceived the idea, designed and performed the surgical procedure, drafted the manuscript and figures. GR Li conceived the initial idea, developed the project and supervised the experiments. HM Xu, BP Wu and XN Wang collected and analyzed the data, wrote the manuscript, observed the complications and developed the illustrations and figures.

Funding source

No funding source was involved.

Author information

Author notes

    Authors and Affiliations

    1. Department of Obstetrics and Gynecology, China Meitan General Hospital, No.29 Xibahe Nanli, Chaoyang District, 100028, Beijing, People’s Republic of China

      Guang-Tai Li & Bao-Ping Wu

    2. China Academy of Chinese Medical Sciences, Wangjing Hospital, Huajiadi Jie, Chaoyang District, 100102, Beijing, People’s Republic of China

      Guang-Rui Li

    3. Department of Obstetrics and Gynecology, Beijing Fengtai Hospital, No. 1 Xi’an Jie, Fengtai District, 100071, Beijing, People’s Republic of China

      Guang-Tai Li, Hong-Mei Xu & Bao-Ping Wu

    4. Fengtai Maternal and Child Hospital, Caihuying, Fengtai District, 100069, Beijing, People’s Republic of China

      Xiao-Nian Wang

    Authors
    1. Guang-Tai Li
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    2. Guang-Rui Li
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    3. Hong-Mei Xu
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    4. Bao-Ping Wu
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    Corresponding author

    Correspondence to Guang-Tai Li.

    Ethics declarations

    The study protocol had been approved by The Local Ethical Committee of Meitan General Hospital.

    Conflict of interests

    The authors declare that they have no conflict of interest.

    Disclosure statement

    The authors declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence their work; there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled.

    Additional information

    G.-T. Li and G.-R. Li contributed equally to this study and share first authorship.

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    Cite this article

    Li, GT., Li, GR., Xu, HM. et al. Uterine folding hemostasis: a simpler and safer technique for controlling atonic postpartum hemorrhage. Arch Gynecol Obstet 294, 689–695 (2016). https://doi.org/10.1007/s00404-016-4009-x

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    • DOI: https://doi.org/10.1007/s00404-016-4009-x

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