LAUSR

Postpartum haemorrhage is one of the leading causes of maternal morbidity and mortality (Maswime and Buchmann 2017). Several haemostatic surgical techniques during caesarean section have been reported previously; among them, double vertical compression sutures are a relatively easy and effective way of achieving haemostasis during caesarean section for placenta previa and uterine atony (Makino et al. 2012). This technique was introduced in the Royal College of Obstetricians and Gynaecologists’ guideline (Mavrides et al. 2017). Tanaka et al. (2014) reported 14 patients with vertical compression sutures; the mean intraoperative blood loss was significantly reduced in these patients, compared to those without compression sutures. Uterine isthmus vertical compression sutures were effective for stopping bleeding from the uterine isthmus and uterine body (Takeda et al. 2016). However, they are associated with the risk of uterine ischemia; thus, in a patient who experiences excessive abdominal pain after receiving vertical compression sutures, the need for uterine blood perfusion must be assessed. When uterine ischemia is found, removal of the compression sutures should be considered (Takeda et al. 2017). In all previous reports, vertical compression sutures for placenta previa were performed during elective caesarean section before the onset of labour. The effectiveness of uterine isthmus vertical compression sutures for emergency caesarean section during trial of labour in a patient with a dilated and effaced cervix has not been evaluated. We experienced a patient who received uterine isthmus vertical compression sutures and needed a contrivance due to an effaced cervix in order to achieve haemostasis.