'Nausicaa' compression suture: a simple and effective alternative to hysterectomy in placenta accreta spectrum and other causes of severe postpartum haemorrhage

BJOG. 2019 Feb;126(3):412-417. doi: 10.1111/1471-0528.15410. Epub 2018 Aug 20.

Abstract

Postpartum haemorrhage (PPH), especially resulting from placenta accreta spectrum (PAS), has become a worldwide concern in maternity care. We describe a novel method of uterine compression sutures (the 'Nausicaa' technique) as an alternative to hysterectomy for patients who have suffered from major PPH. We applied this technique in 68 patients with major PPH during caesarean section (including 43 patients with PAS, 20 patients with placenta praevia totalis, and five patients with uterine atony), and none of these patients required further hysterectomy. We conclude that our Nausicaa suture is a simple and feasible alternative to hysterectomy in patients suffering from major PPH.

Keywords: Placenta accreta spectrum; placenta praevia; postpartum haemorrhage; uterine atony; uterine compression suture; uterus preserving.

MeSH terms

  • Adult
  • Cesarean Section*
  • Female
  • Humans
  • Hysterectomy
  • Massage
  • Middle Aged
  • Misoprostol / therapeutic use
  • Oxytocics / therapeutic use
  • Oxytocin / therapeutic use
  • Placenta Accreta*
  • Placenta Previa*
  • Postpartum Hemorrhage / etiology
  • Postpartum Hemorrhage / surgery*
  • Postpartum Hemorrhage / therapy
  • Pregnancy
  • Severity of Illness Index
  • Suture Techniques*
  • Treatment Failure
  • Uterine Inertia*
  • Young Adult

Substances

  • Oxytocics
  • Misoprostol
  • Oxytocin