Matsubara–Yano suture: a simple uterine compression suture for postpartum hemorrhage during cesarean section
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The aims of this study were to clarify: (i) the effectiveness of Matsubara–Yano uterine compression suture (MY) to achieve hemostasis in the presence of postpartum hemorrhage (PPH) during cesarean section, (ii) the type of PPH for which MY is effective, (iii) post-operative complications of MY, and (iv) outcomes of pregnancy after MY.
This retrospective observational study was performed using medical records of patients for whom MY had been performed between January 1, 2009 and December 31, 2017.
MY was performed for 50 patients, with hemostasis achieved in 46 (92%). The other four (8%: 4/50) patients required transarterial embolization or hysterectomy. Of these four, three patients had placenta accreta spectrum (PAS) disorder-related bleeding. Post-operative complications were observed in three (6%: 3/50) patients, with all showing intrauterine infection. All three patients recovered solely with antibiotics. Eight pregnancies were confirmed (five livebirths, two spontaneous abortions in the first trimester, and one case of ongoing pregnancy). Of the five livebirths, one resulted in cesarean hysterectomy due to placenta previa with PAS disorders.
MY had a hemostatic effect on PPH. All cases except one with hemostatic failure were associated with PAS disorders, indicating that the hemostatic rate was lower in those with PAS than non-PAS disorders.
KeywordsCesarean section Placenta accreta spectrum Postpartum hemorrhage Transarterial embolization Uterine compression suture
Assisted reproductive technology
Matsubara–Yano uterine compression suture
- MT holding
Matsubara–Takahashi holding the cervix
Neonatal intensive care unit
Placenta accreta spectrum
Uterine compression suture
HT: Contributed to the conception and design of the study, data collection, data analysis, and writing of the manuscript. YB and RU: Contributed to the investigation and writing of the manuscript. HS and KH: Contributed to the investigation. HY and AO: Contributed to the conception. SM: Contributed to the conception of the study and writing of the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest and received no funding regarding this study.
All procedures performed in studies involving human participants were conducted in accordance with the provisions of the Declaration of Helsinki. This study was approved by the Ethics Committee of Jichi Medical University.
Not needed (situation described within the manuscript and response letter).
Approval of Institutional Review Board (IRB)
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