Emmert`s Atony Suture for control of post-caesarean haemorrhage

Introduction: The new surgical method was developed to control uterine atony with massive post-caesarean haemorrage refractory to medical measures. The main aim was to achieve an easy, rapid and safe method for use in emergency case. Method: A large round needle with absorbable suture material of 90 cm (Vicryl CTXX) is used. First stitch is to be placed one centimeter lateral and cranial of the uterotomy angle from the anterior to the posterior wall of the uterus. Then the suture runs to the upper lateral part of the uterine fundus, not affecting the Fallopian tube. The second stitch is directed from the posterior to the anterior uterine surface. The third stitch is placed one centimeter lateral and cranial from the uterotomy angle from the anterior to the posterior uterine wall and runs symmetric to the other side. The last stitch is placed from the posterior to the anterior uterine wall. The suture ends will be fixed to pull a knot. The end of the suture will be leaded to the posterior wall and back to the anterior wall, where the second knot is fixed. This keeps the uterus compressed and reduces the uterine perusion and bleeding rapidly. Results: To apply the method only one suture is necessary. The surgeon needs no assistance to perform this suture. Placing the suture lasts only some seconds. Bleeding will stop immediately. The suture can be left in it`s place or can be resolved. Conclusions: The Emmert`s Atony Suture is a safe and rapid method in case of required surgical control of post-caesarean haemorrhage. It is easy to learn, to apply and can avoid hysterectomy.