Hayman Uterine Compression Suture in Upper Egypt

Aim: The current study was performed to evaluate the value of the Hayman uterine compression suture in patients with atonic postpartum hemorrhage (postpartum hemorrhage caused by uterine atony).Methods: This retrospective study was carried out from January 2010 to December 2014 at a tertiary care center in Upper Egypt and involved 82 women with severe atonic postpartum hemorrhage that failed to respond to medical treatment. Data were gathered exclusively from the medical records of patients who underwent the Hayman uterine compression suture. This suture is used to apply mechanical compression on the uterine vascular wall without occluding either the uterine arteries or the uterine cavity. Details regarding risk factors, management, and outcomes were recorded.Results: Good compression of the uterus was achieved and hemostasis was established in 53 (64.63%) women with the Hayman suture alone, and no further interferences were necessary. Twenty-five women needed secondary procedures to achieve good hemostasis, among whom 9 (10.97%) needed uterine devascularization, and 16 (19.51%) needed internal iliac artery ligation. Four women (4.87%) insisted to bleed after application of the compression suture and required hysterectomy because of hemodynamic instability. Thus, using the Hayman suture, hysterectomy could be avoided in 95.12% (78 of 82) of women with postpartum hemorrhage.Conclusion: The Hayman suture is easy and rapid and requires minimal technical skill. This simple procedure should be tried before other complex measures to achieve good hemostasis.