Uterine cavity synechiae after hemostatic square suturing technique

BACKGROUND: A number of surgical techniques to control severe bleeding at cesarean delivery have been proposed, such as uterine artery ligation, hypogastric artery ligation, and uterine compression suturing. CASE: A primigravida with severe postpartum hemorrhage and disseminated intravascular coagulopathy had multiple square sutures placed through the uterus. Serial sonographic follow-up studies revealed uterine synechiae with partial obstruction of menstrual flow. Hysteroscopy confirmed unabsorbed sutures in the uterine cavity. CONCLUSION: The use of multiple sutures through the uterus is effective to control postpartum hemorrhage but may lead to uterine synechiae. (c) 2005 by The American College of Obstetricians and Gynecologists.