Outcomes of subsequent pregnancies after uterine compression sutures for postpartum hemorrhage

Abstract

Objective: To estimate the association between uterine compression sutures for postpartum hemorrhage and subsequent pregnancy outcomes.

Methods: We reviewed the medical records of 336 women who received uterine compression sutures to control postpartum hemorrhage during their first delivery at a single medical center between 2006 and 2011. Of these, 42 women who became pregnant again and received care through our hospital were included in this study. One hundred thirty-nine pregnant women matched for age and parity who did not receive uterine compression sutures during a previous cesarean delivery served as the control group. We compared subsequent pregnancy outcomes and operative findings during repeat cesarean delivery between the two groups.

Results: There were four (9.5%) miscarriages and one (2.4%) tubal pregnancy in the compression suture group compared with 14 (10.1%) miscarriages and two (1.5%) tubal pregnancies in the control group (P=.92 and P=.68, respectively). In the compression suture group, 34 (81.0%) women delivered at term and two (4.7%) women had preterm deliveries. In the control group, 114 (82.0%) women delivered at term and seven (5.0%) women had preterm deliveries (P=.88 and P=.60, respectively). The rate of pelvic adhesions on repeat cesarean delivery was significantly higher in the compression suture group than in the control group (34.3% compared with 17.5%, P=.03).

Conclusions: Subsequent pregnancy outcomes were similar for women who did and those who did not receive uterine compression sutures during their prior delivery, whereas uterine adhesions at repeat cesarean delivery were more prevalent in women who received uterine compression sutures.

Level of evidence: II.