Meydanli compression suture: new surgical procedure for postpartum hemorrhage due to uterine atony associated with abnormal placental adherence.

Aim: To inform about the clinical results of a new uterine compression suture technique used in the surgical management of postpartum hemorrhage due to uterine atony associated with abnormal placental adherence.

Methods: Postpartum hemorrhage due to uterine atony associated with abnormal placental adherence was diagnosed in seven out of 1819 (0.38%) cesarean sections performed between January 2004 and February 2007, and a new uterine compression suture technique was used for surgical management. Age, parity, gestational age and cesarean section indications, amount of transfusion performed, length of hospital stay, postoperative complications, and number of patients in whom the uterus was preserved were evaluated.

Results: The mean age of the cases was 30.5 +/- 3.7 (24-35) years. Cesarean indications were previous cesarean section plus placenta previa totalis in three cases (43%), previous cesarean section in two cases (29%), a twin pregnancy as a result of in vitro fertilization-embryo transfer in one case (14%) and preterm premature rupture of membranes in one case (14%). Six out of seven cases (85%) were successfully treated with the Meydanli compression suture and the uterus was preserved.

Conclusion: The Meydanli compression suture seems to be a simple, quickly applicable and safe uterine compression suture technique, which decreases maternal mortality and peripartum hysterectomy rates.