Alternate Sequential Suture Tightening: A Novel Technique for Uncontrolled Postpartum Hemorrhage

Table 1

Showing diagnoses, treatment, complications, blood loss, and hospital stay.

Age of patient (yrs)	Diagnosis	Preop Hb; (gm%)	Technique	O	Estimated blood loss (mL)	Postop Hb (gm%)	Number of units of blood transfusion	Hospital stay (days)	Complications
29	G2P1L1; 37 wks with fetal distress	8.4	Failed MBLS; ASTS	S	1400	8.9	2	10	Fever for 3 days
24.5	Primi. with 40 weeks; with thick meconium in early labor	7.8	Failed MT; ASTS	S	1900	8.3	3	8	—
35	G5P4L4 with 36 wks; with APH (PP IIb)	9.7	Failed MT; ASTS	S	1600	9.2	1	16	—
33	G3A2 with 41 weeks; with PROM	9.4	Failed MT; ASTS	S	1800	9.3	2	10	—
29	G3A2 with 41 weeks; with CPD	8.9	Failed MT; ASTS	S	1500	9.6	2	8	Superficial infection
31	G3A2 with 37 wks with gestational; HTN with failed induction	10.1	Failed MT; ASTS	S	1900	9.2	1	8	—
26	G2A1 with thick meconium in early labor	8.7	Failed MT; ASTS	S	1800	9.4	2	8	—
36	G5A2P2L2 with 36 wks; with previous 2 LSCS	9.8	Failed MT; ASTS	S	1600	9.4	1	10	Fever for 3 days
37.5	G7AOP6L3 with 38 wks with; placenta previa with APH	7.6	A failed MT; STS	S	1700	9.3	4 with 10 units of FFP	8
28.5	G3A1P1L1 with 39 wks with; prolonged LPV with failed induction	12.2	Failed MT; ASTS	S	1400	11.3		16
30	G4A1P2L1 with 37 wks; with previous 2 LSCS	8	Failed MT; ASTS	S	1300	9.7		10
27	G2P1L1 with 39	9.8	Failed MT; ASTS	S	1600	9.4	1	8	Superficial infection

O: outcome; S: successful; EBL: estimated blood loss; MBLS: modified B-Lynch suture; ASTS: Alternate Sequential Suture Tightening; APH: antipartum hemorrhage; MT: medical treatment; PP: placenta previa; PROM: prelabor rupture of membrane; CPD: cephalopelvic disproportion; LPV: leaking per vagina; FFP: fresh frozen plasma; LSCS: lower segment cesarean section.