Manejo quirúrgico conservador de la hemorragia posparto mediante sutura compresiva uterina (Técnica de Hayman). Reporte de caso

Autores/as

Palabras clave:

Hemorragia Posparto, Atonía Uterina, Suturas de Compresión Uterina, Técnica de Hayman, Postpartum Hemorrhage, Uterine Atony, Uterine Compression Sutures, Hayman Technique

Resumen

La hemorragia posparto es una de las complicaciones más frecuentes en obstetricia, siendo la segunda causa de mortalidad materna a nivel mundial. La atonía uterina es su principal causa. Instaurada la hemorragia, el tiempo y el manejo de la misma dependerá de la experticia del obstetra. Inicialmente el tratamiento se enfoca en el uso de fármacos uterotónicos, pero al no existir una respuesta adecuada se puede optar por un manejo quirúrgico conservador. Las suturas compresivas uterinas son consideradas una buena opción de tratamiento. Una técnica quirúrgica efectiva y
sencilla es la descrita por Hayman, una herramienta valiosa para el control de la hemorragia posparto. Se presenta el caso de una paciente de 17 años, con embarazo de 37 semanas y diagnóstico de preeclampsia grave, quien presenta desprendimiento prematuro de placenta y atonía uterina posterior, a quien se le realizó sutura compresiva uterina por técnica de Hayman, con evolución satisfactoria.

Postpartum hemorrhage is one of the most frequent complications in obstetrics, being the second cause of maternal mortality worldwide. Uterine atony is its main cause. Once the hemorrhage is established, the time and management of it will depend on the expertise of the obstetrician. Initially, treatment focuses on the use of uterotonic drugs, but in the absence of an adequate response, conservative surgical management may be chosen. Compressive uterine sutures are considered a good treatment option. An effective and simple surgical technique is described by Hayman, a valuable
tool for the control of postpartum hemorrhage. We present the case of a 17-year-old patient, 37 weeks pregnant and diagnosed with severe preeclampsia, who presents placental abruption and posterior uterine atony, who underwent uterine compressive suture by Hayman technique, with satisfactory evolution.

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Citas

Pacagnella RC, Borovac-Pinheiro A. Assessing and managing hypovolemic shock in puerperal women. Best Pract Res Clin Obstet Gynaecol. 2019;61:89-105. DOI: 10.1016/j.bpobgyn.2019.05.012.

Bienstock JL, Eke AC, Hueppchen NA. Postpartum Hemorrhage. N Engl J Med. 2021 Apr 29;384(17):1635-1645. DOI: 10.1056/NEJMra1513247.

Parry Smith WR, Papadopoulou A, Thomas E, Tobias A, Price MJ, Meher S, et al. Uterotonic agents for first-line treatment of postpartum haemorrhage: a network meta-analysis. Cochrane Database Syst Rev. 2020 24;11(11):CD012754. DOI: 10.1002/14651858. CD012754.pub2.

Federación Argentina de Sociedades de Ginecología y Obstetricia FASGO [Internet]. Buenos Aires: Actualización de Consenso de Obstetricia FASGO 2019. Hemorragia postparto; 2019 [consultado el 5 de marzo de 2021]. Disponible en: http://www.fasgo.org.ar/archivos/consensos/Consenso_2019_Hemorragia_

Post_Parto.pdf

Ende HB, Lozada MJ, Chestnut DH, Osmundson SS, Walden RL, Shotwell MS, et al. Risk factors for atonic postpartum hemorrhage: A systematic review and meta-analysis. Obstet Gynecol. 2021;137(2):305-323. DOI: 10.1097/AOG.0000000000004228.

Neary C, Naheed S, McLernon DJ, Black M. Predicting risk of postpartum haemorrhage: a systematic review. BJOG. 2021;128(1):46-53. DOI: 10.1111/1471-

16379.

Pingray V, Widmer M, Ciapponi A, Hofmeyr GJ, Deneux C, Gülmezoglu M, et al. Effectiveness of uterine tamponade devices for refractory postpartum haemorrhage after vaginal birth: a systematic review. BJOG. 2021;128(11):1732-1743. DOI: 10.1111/1471-0528.16819.

Ghosh SB, Mala YM. Alternate sequential suture tightening: a novel technique for uncontrolled postpartum hemorrhage. Obstet Gynecol Int. 2015;2015:145178. DOI: 10.1155/2015/145178.

Mallappa Saroja CS, Nankani A, El-Hamamy E. Uterine compression sutures, an update: review of efficacy, safety and complications of B-Lynch suture and other uterine compression techniques for postpartum haemorrhage. Arch Gynecol Obstet.

;281(4):581-588. DOI: 10.1007/s00404-009-1249-z.

Matsuzaki S, Jitsumori M, Hara T, Matsuzaki S, Nakagawa S, Miyake T, et al. Systematic review on the needle and suture types for uterine compression sutures: a literature review. BMC Surg. 2019;19(1):196. DOI: 10.1186/s12893-019-0660-z.

Committee on Practice Bulletins-Obstetrics. Practice Bulletin No. 183: Postpartum Hemorrhage. Obstet Gynecol. 2017;130(4):e168-e186. DOI: 10.1097/AOG.0000000000002351.

B-Lynch C, Coker A, Lawal AH, Abu J, Cowen MJ. The B-Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported. Br J Obstet Gynaecol. 1997;104(3):372-5. DOI: 10.1111/j.1471-

1997.tb11471.x.

Moleiro ML, Braga J, Machado MJ, Guedes-Martins L. Uterine compression sutures in controlling postpartum haemorrhage: A narrative review. Acta Med Port. 2022;35(1):51-58. DOI: 10.20344/amp.11987.

Cho JH, Jun HS, Lee CN. Hemostatic suturing technique for uterine bleeding during cesarean delivery. Obstet Gynecol. 2000;96(1):129-131. DOI: 10.1016/s0029-7844(00)00852-8.

Hayman RG, Arulkumaran S, Steer PJ. Uterine compression sutures: surgical management of postpartum hemorrhage. Obstet Gynecol. 2002;99(3):502-506. DOI: 10.1016/s0029-7844(01)01643-x.

Moreno-Santillán AA, Posadas-Nava A, MartínezAdame LM. Sutura compresiva de Hayman: experiencia de cuatro años. Ginecol Obstet Mex. 2018; 86(09):590-596. DOI: 10.24245/gom. v86i9.1992.

Nanda S, Singhal SR. Hayman uterine compression stitch for arresting atonic postpartum hemorrhage: 5 years’ experience. Taiwan J Obstet Gynecol. 2011;50(2):179-181. DOI: 10.1016/j.tjog.2009.12.001.

Ghezzi F, Cromi A, Uccella S, Raio L, Bolis P, Surbek D. The Hayman technique: a simple method to treat postpartum haemorrhage. BJOG. 2007;114(3):362-

DOI: 10.1111/j.1471-0528.2006.01204.x.

Kwong LT, So PL, Wong SF. Uterine compression sutures with additional hemostatic procedures for the management of postpartum hemorrhage. J Obstet

Gynaecol Res. 2020;46(11):2332-2339. DOI: 10.1111/jog.14426.

Subbaiah M, Chaturvedula L, Kubera NS, Raj A. Subsequent pregnancy outcome after uterine compression suture placement for postpartum hemorrhage. Int J Gynaecol Obstet. 2022;156(3):475-480. DOI: 10.1002/ijgo.13710.

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Publicado

2023-05-08