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Research article
Joong Sik Shin
CHA Gangnam Medical Center, CHA University
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6593-6561
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Introduction : Twin pregnancy has a high risk for developing uterine atony (UA). This study aimed to evaluate efficacy and clinical outcomes of prophylactic compression sutures to treat UA during the twin cesarean section (CS).
Materials and Methods : All patient records of twin pregnancies in a large maternity hospital in South Korea between January 2013 and June 2018 were reviewed. Patients with monochorionic monoamniotic twins, fetal loss of one or both fetus before 20 gestational weeks, twins delivered prior to 24 gestational weeks, and patients who were delivered twins vaginally were excluded from data analysis. In total, 953 women were eligible for data analysis.
Results : Of the 953 patients, compression sutures were applied to 147 cases refractory to uterine massage and uterotonics. Of 147, two patients (1.4%) proceeded to additional uterine artery ligation to achieve hemostasis, yielding a success rate of 98.6%. The rate of transfusion after the first 24 hours of delivery in the suture group was not significantly different from that in the non-suture group, suggesting that both groups achieved hemostasis at an equal rate after the first 24 hours of delivery. The difference in the operation time between the two groups was only 8.5 minutes. The rate of subsequent pregnancy among the patients who received compression sutures was 44.4%.
Conclusions : Overall, our findings suggest that with early and fast implementation of compression sutures, UA can be treated in the setting of twin cesarean delivery without significantly increasing maternal morbidity.
Keywords
Twin pregnancy, Uterine atony, Compression suture, Postpartum hemorrhage
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View the published article at BMC Pregnancy and Childbirth.
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Reviewer #1 agreed
On 19 Dec, 2019
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Received 19 Dec, 2019
Reviewer #2 agreed
On 19 Dec, 2019
Review #2 received
Received 19 Dec, 2019
Editor assigned
On 18 Dec, 2019
Reviewers invited
Invitations sent on 18 Dec, 2019
Submission checks complete
On 17 Dec, 2019
Editor invited
On 17 Dec, 2019
Version 1
Posted 14 Nov, 2019
No comments provided
Editorial decision: Major revision
On 02 Dec, 2019
Review #4 received
Received 27 Nov, 2019
Review #2 received
Received 27 Nov, 2019
Review #3 received
Received 27 Nov, 2019
Reviewer #7 agreed
On 26 Nov, 2019
Review #1 received
Received 25 Nov, 2019
Reviewer #6 agreed
On 24 Nov, 2019
Review #5 received
Received 23 Nov, 2019
Reviewer #5 agreed
On 22 Nov, 2019
Reviewers invited
Invitations sent on 21 Nov, 2019
Reviewer #1 agreed
On 21 Nov, 2019
Reviewer #2 agreed
On 21 Nov, 2019
Reviewer #3 agreed
On 21 Nov, 2019
Reviewer #4 agreed
On 21 Nov, 2019
Editor assigned
On 28 Oct, 2019
Submission checks complete
On 27 Oct, 2019
Editor invited
On 27 Oct, 2019
First submitted
On 26 Oct, 2019
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Subject Areas
Maternal & Fetal Medicine
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A new preprint design is coming!
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See the published version of this preprint at BMC Pregnancy and Childbirth.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Joong Sik Shin
CHA Gangnam Medical Center, CHA University
Corresponding Author
ORCiD: https://orcid.org/0000-0001-6593-6561
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pregnancy and Childbirth.
No community comments so far
Reviewer #1 agreed
On 19 Dec, 2019
Review #1 received
Received 19 Dec, 2019
Reviewer #2 agreed
On 19 Dec, 2019
Review #2 received
Received 19 Dec, 2019
Editor assigned
On 18 Dec, 2019
Reviewers invited
Invitations sent on 18 Dec, 2019
Submission checks complete
On 17 Dec, 2019
Editor invited
On 17 Dec, 2019
Version 1
Posted 14 Nov, 2019
No comments provided
Editorial decision: Major revision
On 02 Dec, 2019
Review #4 received
Received 27 Nov, 2019
Review #2 received
Received 27 Nov, 2019
Review #3 received
Received 27 Nov, 2019
Reviewer #7 agreed
On 26 Nov, 2019
Review #1 received
Received 25 Nov, 2019
Reviewer #6 agreed
On 24 Nov, 2019
Review #5 received
Received 23 Nov, 2019
Reviewer #5 agreed
On 22 Nov, 2019
Reviewers invited
Invitations sent on 21 Nov, 2019
Reviewer #1 agreed
On 21 Nov, 2019
Reviewer #2 agreed
On 21 Nov, 2019
Reviewer #3 agreed
On 21 Nov, 2019
Reviewer #4 agreed
On 21 Nov, 2019
Editor assigned
On 28 Oct, 2019
Submission checks complete
On 27 Oct, 2019
Editor invited
On 27 Oct, 2019
First submitted
On 26 Oct, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Pregnancy and Childbirth.
Introduction : Twin pregnancy has a high risk for developing uterine atony (UA). This study aimed to evaluate efficacy and clinical outcomes of prophylactic compression sutures to treat UA during the twin cesarean section (CS).
Materials and Methods : All patient records of twin pregnancies in a large maternity hospital in South Korea between January 2013 and June 2018 were reviewed. Patients with monochorionic monoamniotic twins, fetal loss of one or both fetus before 20 gestational weeks, twins delivered prior to 24 gestational weeks, and patients who were delivered twins vaginally were excluded from data analysis. In total, 953 women were eligible for data analysis.
Results : Of the 953 patients, compression sutures were applied to 147 cases refractory to uterine massage and uterotonics. Of 147, two patients (1.4%) proceeded to additional uterine artery ligation to achieve hemostasis, yielding a success rate of 98.6%. The rate of transfusion after the first 24 hours of delivery in the suture group was not significantly different from that in the non-suture group, suggesting that both groups achieved hemostasis at an equal rate after the first 24 hours of delivery. The difference in the operation time between the two groups was only 8.5 minutes. The rate of subsequent pregnancy among the patients who received compression sutures was 44.4%.
Conclusions : Overall, our findings suggest that with early and fast implementation of compression sutures, UA can be treated in the setting of twin cesarean delivery without significantly increasing maternal morbidity.
Figure 1
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