Effectiveness of compression of myometrium and occlusion of uterine artery by COMOC-MG suture in management of atonic postpartum hemorrhage

Background: Postpartum haemorrhage (PPH) remains a significant cause of maternal morbidity and mortality globally, with uterine atony being a primary etiological factor. This prospective interventional study aimed to assess the effectiveness of the compression of myometrium and occlusion of uterine artery by COMOC-MG suture technique in managing atonic PPH. Methods: A prospective study was conducted at GK general hospital, Bhuj, Gujarat, from December 2020 to July 2022. The study enrolled 100 pregnant women without identified risk factors undergoing complicated caesarean or vaginal deliveries. The COMOC-MG suture technique was employed for the study group, while the control group received standard atonic PPH management. Outcomes included success rates, blood transfusion needs, complications, and mortality. Results: The study group (n=50) demonstrated comparable demographic characteristics to the control group. Notably, the COMOC-MG group exhibited higher success rates in normal (100%) and cesarean deliveries (95.3%) compared to the control group (72.7% and 60.7%, respectively). Lower blood transfusion needs (34% vs. 48%) and fewer complications were observed in the COMOC-MG group. Hemoglobin (Hb) levels on post-partum day 1 showed no significant difference. Conclusions: The study suggests that COMOC-MG suture technique is effective in managing atonic PPH, showing superior success rates and potentially reducing blood transfusion needs. While further research, including larger trials, is warranted, these findings underscore promise of COMOC-MG as an innovative intervention in obstetric care, offering potential benefits in maternal outcomes. The observed safety profile supports its consideration in clinical practice.