The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
September 8, 2026 · via Europe PMC
Clinical characteristics and outcomes of uterine compression sutures for postpartum hemorrhage during cesarean delivery.
Kojima T, Obata S, Hiiragi K, Kamihara Y, Nakanishi S, Shindo R, Miyagi E, Aoki S.
AI summary — for doctors, generated from the abstract only
Uterine compression sutures achieved haemostasis in about 70% of postpartum haemorrhage cases at caesarean, with suspected placenta accreta spectrum marking those likely to need escalation.
What was studied
A single-centre retrospective cohort of 33 patients who underwent uterine compression sutures for postpartum haemorrhage during caesarean delivery between January 2011 and July 2025, comparing those managed with sutures alone against those needing arterial embolisation or hysterectomy.
Key findings
- Sutures alone achieved haemostasis in 23/33 (69.7%); 10 (30.3%) needed escalation (embolisation n=3, hysterectomy n=7)
- Suspected placenta accreta spectrum in 60.0% of those needing escalation vs 8.7% managed with sutures alone (p=0.004)
- 6 of 8 patients with PAS (75.0%) required escalation
- All 4 patients with placental abruption achieved haemostasis with sutures alone
- Higher estimated blood loss and ICU admission in the escalation group
- Uterine preservation achieved in 26/33 (78.8%)
Clinical relevance
This raises the question of whether suspected placenta accreta spectrum should prompt earlier readiness for embolisation or hysterectomy rather than relying on compression sutures; with only 33 patients from one centre the authors themselves frame it as hypothesis-generating.
Who should care
Limitations
Very small single-centre retrospective series spanning 14 years of changing practice, with few events, so the reported predictors are not definitive.
Compression sutures work for most postpartum bleeding at caesarean, but an abnormally adherent placenta should have you planning the next step in advance.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
Uterine compression sutures (UCS) serve as a uterus-preserving option for the management of postpartum hemorrhage (PPH); however, the clinical characteristics associated with the need for additional treatment after UCS remain incompletely characterized. This study aimed to explore clinical factors associated with escalation to additional treatment after UCS.
Methods
We conducted a single-center retrospective cohort analysis of 33 patients who underwent UCS for PPH during cesarean delivery between January 2011 and July 2025. Patients were categorized based on management with UCS alone or the requirement for additional interventions, including transcatheter arterial embolization (TAE) or emergency peripartum hysterectomy (EPH).
Results
UCS alone achieved hemostasis in 23 patients (69.7%), whereas 10 patients (30.3%) required additional treatment (TAE, n = 3; EPH, n = 7). The incidence of suspected placenta accreta spectrum (PAS) was higher among patients requiring additional treatment than among those managed with UCS alone (60.0% vs. 8.7%; p = 0.004). Six of the eight patients with PAS (75.0%) required escalation, whereas all four patients with placental abruption achieved hemostasis with UCS alone; however, this finding should be interpreted cautiously because of the small number of cases. The estimated blood loss and intensive care unit admission rates were higher in the group requiring additional treatment. Ultimately, uterine preservation was achieved in 26 (78.8%) patients.
Conclusion
In this small retrospective cohort, UCS achieved hemostasis in many patients with PPH during cesarean delivery. Suspected PAS, particularly when complicated by placenta previa or a low-lying placenta, was associated with a higher need for additional treatment after UCS. However, because of the small sample size and limited number of events, these findings should be interpreted as hypothesis-generating rather than as definitive predictors of UCS failure.
DOI
10.1080/14767058.2026.2726056
PMID
42708884
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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