Effect of early "quilting" sutures on morbidity in postpartum hemorrhage

Abstract

Objective: To examine whether "quilting" sutures are safe and effective in preventing hysterectomy among women with postpartum hemorrhage (PPH) and whether early application might reduce the incidence of transfusion.

Methods: Data were reviewed from women treated via quilting sutures after cesarean delivery at a university hospital between 2007 and 2016. Objective and subjective data were collected by analyzing medical records and performing telephone interviews. To observe trends during the study period, data from the first 50% of women treated were compared with those from the second 50%.

Results: Overall, 26 cesareans with quilting sutures were performed. Two hysterectomies could not be avoided. During 2012-2106, 18 quilting sutures were performed as compared with 8 in 2007-2011, pointing to a more liberal indication. Intensive care was required twice as frequently among the first 13 procedures than among the second 13 procedures (10 vs 5, respectively). A similar observation was made for the use of blood transfusions or clotting activation (9 vs 4, respectively). Three women who desired to have a child subsequently delivered a newborn.

Conclusion: Quilting sutures were found to be a safe and simple technique to prevent hysterectomies in PPH. Morbidity was reduced when the decision to perform sutures was taken early.

Keywords: Cesarean; Compression sutures; Hysterectomy; Postpartum hemorrhage; Quilting sutures.