Title: - “Management of PPH (Placental Site Bleeding) by a new
Haemostatic Suture: In Eleven cases of PPH during Caesarean section”.
Concept : - It is an established Anatomical fact that the spiral
arterioles pass through the interlacing muscle fibers of uterus. These
are the blood supply to placenta for fetal oxygen and nutrition(1) .
After delivery of fetus and placenta effective contraction and
retraction of the interlacing muscle fibres of uterus compresses the
arterioles passing through it to get a good haemostasis. With this
concept in cases of PPH after excluding trauma to genital tract, the
bleeding sinus from placental site was searched by Sadhna’s four finger
technique in the uterine cavity. After locating the bleeder based on the
above anatomical concept the overlying area of about one cm squares was
taken in a figure of 8 haemostatic suture (Saravi’s Suture). This suture
invariably resulted in good haemostasis.
Abstract: This study includes 11 cases of PPH seen during
Caesarean section by a single surgeon Dr. Sadhna Mathur during the last
7years where this hemostatic suture was used to control PPH from
placental site in uterine cavity after the medical measures failed to
control the bleeding from placental site(uterine cavity). The bleeding
point was localized and a haemostatic suture in the overlying uterine
musculature was applied. It was found to be completely effective hence
it is being shared through this paper.
Introduction: - Primary post partum hemorrhage is known for its
significant role in maternal mortality and morbidity since ages(1) After delivery of fetus and placenta the bleeding from torn
placental sinuses is effectively controlled by contraction and
retraction of uterine musculature in majority of the cases. But in some
cases one or more of theses continue to bleed either due to focal atony
or torn sinus not occluded well by this nature’s ligature.