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.