Efficacy of Hayman Suture in the Treatment of Atonic Postpartum Hemorrhage

Ahmed M Abdul Hameed,Mohamed S Fahmy,Haney A Farouk

doi:10.47631/jsrmbs.v2i4.330

Ahmed M Abdul Hameed, Mohamed S Fahmy + Show 1 more

Open Access

https://doi.org/10.47631/jsrmbs.v2i4.330

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Abstract

Purpose: The study aims to investigate the effectiveness of Hayman’s suture in the management of Atonic postpartum hemorrhage. Subjects and Method: The study includes 37 patients who developed severe atonic PPH not responsive to pharmacological measures at the Department of Obstetrics and Gynecology at Aswan University hospital, in the period between Mars 2018 and December 2019. This is a case series study of 37 patients upon whom Hayman suture is applied when failed to respond to medical management, step-wise devascularization of the uterus is attempted when the suture cannot control the bleeding alone, reserving hysterectomy as a last resort when all measures are failed. Results: Results of the research None of the 37 patients of our study required hysterectomy to control the bleeding, Hayman suture succeeded solely to arrest the hemorrhage in 30 patients (81.1%), while 7 patients(18.9%) required step-wise devascularization of the uterus with Hayman suture to stop the bleeding. It is not uncommon for complications to be described with the use of uterine compression sutures. In our study, we did not report any complications. Conclusion: The application of Hayman’s suture is a fast, efficient, non-complex, lifesaving and fertility-sparing technique to control atonic postpartum hemorrhage.

Highlights

Postpartum hemorrhage (PPH) is a major cause of maternal mortality worldwide ranging from 13% in developed countries to 34% in developing countries (Say et al, 2014)
All of the study subjects delivered by C.S in which the abdomen was already open, Hayman suture was applied as described in the original report (Hayman et al, 2002), if the bleeding hadn’t stopped, stepwise devascularization of the uterus was done to control the Postpartum hemorrhage
In another study done in Upper Egypt (Fahmy et al, 2016), shows that Hayman suture only succeeded in 64.63% of cases, while the additional intervention was required for 30.48% of patients

Summary

Introduction

Postpartum hemorrhage (PPH) is a major cause of maternal mortality worldwide ranging from 13% in developed countries to 34% in developing countries (Say et al, 2014). Hayman suture succeeded as the only intervention in 30 cases of the total 37 (81.1%), while it needed another intervention (bilateral uterine artery ligation) to control the hemorrhage in 7 cases (18.9%). Atonic PPH is considered the most frequent cause of obstetrical hemorrhage where there is the failure of the uterus to contract sufficiently after delivery and to arrest bleeding from vessels at the placental implantation site.

Results

Conclusion