Objective: We introduced two novel hemostatic techniques to achieve hemostasis\nfor postpartum hemorrhage (PPH). The first one (A: Uterus Isthmic\nPlication) was a new uterine compression suture, which compresses the hysterotomy\nsite. In a severe case, we further added vessel ligation suture after\nperforming A-suture (B-combination suture: B-suture: A + Wide Lateral Uterine\nVascular Ligation). Methods: Of 140 PPH cases, 90 were with mild PPH\nand 40 were with severe PPH. Our policy was: perform A-suture to mild PPH\nand perform B (combination) to severe PPH. Study was performed during\n2018-2019. The primary endpoint to evaluate the efficacy of the procedures\nwas preserving the uterus (no hysterectomy). Results: A-procedure, performed\nto 90 patients with mild PPH, was effective to all 90 patients, with all preserving\nthe uterus. B-procedure, performed 38 patients with severe PPH (excluding\ntwo patients with uterine rupture), was effective in 37 patients, with\none having undergone hysterectomy due to coagulopathy. Conclusion: Uterus\nIsthmic Plication (A-procedure) and addition of Wide Lateral Uterine\nVascular Ligation to procedure-A (B-procedure) achieved hemostasis in patients\nwith PPH. Prospective study is necessary to confirm the present data.
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