Uterine necrosis - A complication of uterine compression sutures

BACKGROUND: In cases of uterine atony, uterine compression sutures work by applying direct uterine compression. CASE: A 33-year-old gravida 2, para 0101 with preterm premature rupture of the membranes at 31 and 4/7 weeks of gestation underwent cesarean delivery. Because of significant uterine atony, two uterine compression sutures were placed. On postoperative day 8, the patient returned to the operating room secondary to persistent fevers not responsive to antibiotic therapy. At the time of laparotomy, she was found to have fundal uterine necrosis at the location of the second compression suture. CONCLUSION: This case demonstrates uterine necrosis confined to the uterine fundus after placement of a compression suture in this area. Although brace sutures are an invaluable technique for patients with uterine atony, uterine necrosis is a rare complication.