Discussion: -
In obstetrics practice in cases with atonic PPH when the medical measures fail, the different methods have been devised by different surgeons to stop bleeding.
A study conducted by J. Seror et al. in 2005 (2) found balloon tamponade to be associated with risk of infection and resumption of bleeding after taking it out, in 17.06% cases in a large series. The patients in whom bleeding restarted were shifted for uterine artery embolization.
Different compression sutures have been devised to oppose the walls of the uterine cavity and also to reduce blood supply to the uterus at the same time, to achieve haemostasis at placental site (3) . Compression sutures practiced are:
  1. B Lynch Compression Suture (1)
  2. Hayman’s Sutures (4)
  3. CHO’s Square Sutures (5)
  4. Mansoura VV sutures (6)
These compression sutures required a skilled obstetrician for the technique as optimum degree of tension to achieve compression of the large bulk of tissue is required while tying the knot without getting cut through.
Saad Benkirane, at all 2017 (7) has reported uterine necrosis following combination of uterine compression sutures with vascular ligation done during postpartum haemorrhage. The other reported complications are pyometra erosion of strap through the uterine wall, uterine ischaemia and synechie. The frequency of complications still remain unclear.
To overcome the aforesaid complications, removable uterine compression sutures were devised by Zhang ZW 2015(8) , but they found the method of suture removal to be cumbersome.
The present study includes a limited number of cases but we hope if this method is practiced at a larger level where ever required in future it will be a step overcoming many problems in the management of PPH.