Efficacy of the Nausicaa Compression Sutures for Postpartum Hemorrhage Management

Abstract

Background and Objective: Postpartum haemorrhage(PPH) is still the most important cause of matemg|
death in Pakistan. Over 125,000 maternal deaths have been reported cach year due to PPH worldwide. Major
causes of PPH include uterine atony and hacmorrhage from the placental bed. The recent increase in the rage
of cesarean section has increased the incidence of the Placenta previa acereta spectrum. Apart from medicq|
measures, there are various conservative surgical interventions before imparting hysterectomy such ag
uterine compression sutures, hemostatic sutures, and stepwise devascularization of the pelvis which
effectively control hemorrhage and save the mother from life-threatening morbidities. The Nausica
compression suture is a novel technique that effectively controls PPH in patients with uterine atony, placenta
previa, and accrete spectrum. The objective of this study is to determine the efficacy of Nausicaa compression
sutures in patients with PPH undergoing cesarcan section.
Methods: This study was conducted in the Obstetrics and Gynaecology department of Sir Ganga Ram
Hospital, Lahore from 1st September 2020 to 30th June 2022. A total of 80 patients who had PPH during
cesarean section due to uterine atony or placenta previa spectrum were enrolled after informed consent,
Nausicaa compression suture was applied to the anterior, posterior, and both uterine walls where required.
Successful procedures were those where only the Nausicaa compression suture was sufficient to control PPH,
Results: The average age of patients was 30.3+4.2 years. There were 24(30%) primigravidas, 28(35%)
G2P1-+0 and 28(35%) were multigravidas. The mean gestational age of patients was 37 weeks. In 09 cases,
Nausicaa sutures were applied to the anterior uterine wall while in 71 patients to both anterior and posterior
uterine walls. Out of 80 patients, 62 patients were saved from interactable hacmorrhage due to Nausicaa
Compression sutures.
Conclusion: The Nausicaa compression suture is an cffective and new suture to control postpartum
hemorrhage in patients with placenta previa spectrum and atonic uterus. It is most effective when applied to
anteriorand posterior both uterine walls separately.