Vol.:(0123456789) 1 3 Archives of Gynecology and Obstetrics (2019) 299:113–121 https://doi.org/10.1007/s00404-018-4947-6 MATERNAL-FETAL MEDICINE Matsubara–Yano suture: a simple uterine compression suture for postpartum hemorrhage during cesarean section Hironori Takahashi 1  · Yosuke Baba 1  · Rie Usui 1  · Hirotada Suzuki 1  · Kenji Horie 1  · Hitoshi Yano 1  · Akihide Ohkuchi 1  · Shigeki Matsubara 1 Received: 18 March 2018 / Accepted: 17 October 2018 / Published online: 24 October 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Aims The aims of this study were to clarify: (i) the efectiveness 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 efective, (iii) post-operative complications of MY, and (iv) outcomes of pregnancy after MY. Methods 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. Results 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 confrmed (fve livebirths, two spontaneous abortions in the frst trimester, and one case of ongoing pregnancy). Of the fve livebirths, one resulted in cesarean hysterectomy due to placenta previa with PAS disorders. Conclusions MY had a hemostatic efect 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. Keywords Cesarean section · Placenta accreta spectrum · Postpartum hemorrhage · Transarterial embolization · Uterine compression suture Abbreviations ART Assisted reproductive technology BW Birth weight CH Cesarean hysterectomy CS Cesarean section IQR Interquartile range MY Matsubara–Yano uterine compression suture MT holding Matsubara–Takahashi holding the cervix NICU Neonatal intensive care unit PAS Placenta accreta spectrum PPH Postpartum hemorrhage SA Spontaneous abortion TAE Transarterial embolization UCS Uterine compression suture * Hironori Takahashi hironori@jichi.ac.jp Yosuke Baba ybabati@jichi.ac.jp Rie Usui satori@jichi.ac.jp Hirotada Suzuki killip@jichi.ac.jp Kenji Horie r0946kh@jichi.ac.jp Hitoshi Yano yanoh@yomogi.ne.jp Akihide Ohkuchi okuchi@jichi.ac.jp Shigeki Matsubara matsushi@jichi.ac.jp 1 Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan