What is it about?
We present the case of a rare postpartal complication. During c-section a woman had received compression sutures. Six weeks later she presented with the Prolapse of the omentum. The anterior wall of the Uterus had become necrotic due to the compression sutures. We furthermore give an overview of published cases of necrosis due to compression sutures.
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Why is it important?
Postpartum or peripartum hemorrhage is a major cause of maternal death in Western industrialized countries. Fertility preserving second stage interventions are very important, but also bear the risk of complications.
Perspectives
Compression sutures are an important fertility preserving measure in cases of postpartum hemorrhage, but they bear the risk of subsequent necrosis of the uterus. Hence, we advise the careful consideration before application of compression sutures. Bigger prospective studies are needed to answer the questions about the best suture material and suture technique discussed above. A proposed solution is the establishment of a national registry to document both successful and unsuccessful applications of compression sutures and prospectively monitor short- and longterm maternal morbidity. We strongly support this endeavor and recommend a broadening to an international registry enabling the investigation of bigger numbers in shorter course of time. As some of the reported cases of uterine necrosis are criticized for misapplication of the respective technique, we strongly encourage systematic training for residents in the management of postpartum hemorrhage.
Vera Seidel
Read the Original
This page is a summary of: Vaginal omentum prolapse due to uterine anterior wall necrosis after prophylactic compression suture for postpartum hemorrhage: case report and review of the literature, Case Reports in Perinatal Medicine, June 2017, De Gruyter,
DOI: 10.1515/crpm-2016-0074.
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