Vaginal bilateral cervical lips suture in combination with intrauterine Foley catheter to arrest postpartum hemorrhage

Abstract

Vaginal bilateral cervical lips suture allows retention of intrauterine Foley catheter in women with a dilated cervix. This novel indication for vaginal bilateral cervix suture may be a useful adjunct to intrauterine balloon tamponade in the management of postpartum hemorrhage. Objective: To describe an effective, minimally invasive surgical technique for avoiding intrauterine balloon tamponade prolapse. Materials and Methods: This procedure was performed in the delivery room with or without bladder retraction. The cervix was grasped with two ring forceps and firmly pulled outward, two cm horizontal suture of the cervical lips was made at both the three and nine o’clock positions, which were placed two cm as close to the cervix external os, without transversing the cervicovesical reflection anteriorly and the pouch of Douglas posteriorly, then one or more Foley catheters were inserted through the cervix and inflated with saline 60-80 ml each. Results: The balloons remained in place and hemorrhage abated in all nine cases. Conclusion: vaginal bilateral cervical lips suture can prevent intrauterine balloon prolapse, which may be a useful adjunct to intrauterine balloon tamponade in management of postpartum hemorrhage.