{"title":"Uterine Necrosis Following Uterine Compression Sutures in Severe Postpartum Hemorrhage: A Case Report and Literature Review.","authors":"Jianyang Lu, Hongbo Zhai","doi":"10.1002/jcu.24068","DOIUrl":null,"url":null,"abstract":"<p><p>Uterine compression sutures (UCS) are effective in treating severe atonic postpartum hemorrhage. We report a rare case of uterine necrosis following UCS combined with vascular ligation, which is a severe complication. The patient manifested persistent high fever with leukocytosis and a sub-involuted uterus after the procedure. Ultrasound combined with enhanced computed tomography (CT) is useful for the early diagnosis of uterine necrosis. Ultrasonography may show diffuse uterine enlargement, a heterogeneous myometrium, mixed mass signals, discontinuity of the myometrium, and poor blood flow signals. CT scans may reveal asymmetric density of the myometrium and loss of enhancement. Hysterectomy is the appropriate treatment. KEY CLINICAL MESSAGE: The uterine compression sutures combined with other hemostatic procedures during postpartum hemorrhage can increase the risk of uterine necrosis. Close observation is necessary to promptly recognize and manage this serious complication.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Ultrasound","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jcu.24068","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ACOUSTICS","Score":null,"Total":0}
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Abstract
Uterine compression sutures (UCS) are effective in treating severe atonic postpartum hemorrhage. We report a rare case of uterine necrosis following UCS combined with vascular ligation, which is a severe complication. The patient manifested persistent high fever with leukocytosis and a sub-involuted uterus after the procedure. Ultrasound combined with enhanced computed tomography (CT) is useful for the early diagnosis of uterine necrosis. Ultrasonography may show diffuse uterine enlargement, a heterogeneous myometrium, mixed mass signals, discontinuity of the myometrium, and poor blood flow signals. CT scans may reveal asymmetric density of the myometrium and loss of enhancement. Hysterectomy is the appropriate treatment. KEY CLINICAL MESSAGE: The uterine compression sutures combined with other hemostatic procedures during postpartum hemorrhage can increase the risk of uterine necrosis. Close observation is necessary to promptly recognize and manage this serious complication.
期刊介绍：
The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography.
The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents.
JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.
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