Uterine Mesh Compression Suture: A Modified Therapeutic Approach for Refractory Postpartum Hemorrhage

Abstract Objective: To investigate the application value of a novel suture technique—uterine mesh compression suture (UMCS)—in the management of refractory postpartum hemorrhage (PPH). Methods: A retrospective analysis was performed on 45 patients with refractory PPH who underwent UMCS, evaluating the surgical efficacy and safety. Clinical data, including hemostatic effect, postoperative complications, reproductive function outcomes, and long-term follow-up results, were systematically analyzed. Results: In all cases, active uterine bleeding ceased within 5–10 minutes after UMCS. Cumulative vaginal blood loss was <20 mL within 2 hours postoperatively, confirming effective hemostasis. Magnetic resonance imaging (MRI) on day 4 revealed no intrauterine effusion; Postoperative hormone assays showed all values within normal ranges at 5 days postoperatively; At 42 days postoperatively, both ultrasound and MRI demonstrated normal uterine structure without abnormalities. Hysteroscopic examination at 6 months showed no intrauterine adhesions, with clear patency of fallopian tube ostia. During follow-up, 45 patients resumed normal menstruation 1–2 months after stopping breastfeeding. Ten patients achieved subsequent pregnancy, including 4 who underwent repeat cesarean delivery and 6 who terminated pregnancy via induced abortion, with no reported complications related to the suture technique. Conclusion: UMCS effectively controls PPH caused by uterine atony. This technique is recommended for patients with refractory PPH due to uterine atony who fail traditional hemostatic measures, or for cases of intraoperative bleeding ≥1500 mL during cesarean section, where UMCS can be performed directly as a first-line intervention.