Novel LUS Compression Sutures for Previa Bleeding

Uterine compression sutures are effective, uterus-sparing techniques for managing severe postpartum hemorrhage (PPH) due to atony, avoiding hysterectomy. Key types include the B-Lynch suture (vertical, brace-like), Hayman suture (simplified vertical), and Pereira sutures (multiple, comprehensive sutures), and Cho Compression (quadrant square anterior to posterior closures), are applied when pharmacological methods fail. But these, while helpful with atony, do not address the LUS bleeding from previa which are below these applications. Even the O’Leary lateral sutures are often higher tha the bleeding and thin, anterior LUS affected by previa. Previa is a significant risk factor for PPH. In this episode, we will highlight 3 novel suture techniques which have been in print (TWO as recent as January 2026) which can be effective in stopping the LUS bleeding and avoiding hysterectomy. We will highlight the transverse circumferential purse string, the simple transverse Nausicaa suture, and the LUS WaveForm suture. These are easy to use and may be lifesaving.

1. The Nausicaä suture in the management of the placenta accreta spectrum: Shih J, Li J, Kang J .The Nausicaä suture in the management of the placenta accreta spectrum. AJOG. Jan 2026: 233, S671-S688 S

2. Transverse Purse String Suture for Placenta Previa in the Presence of Previous Cesarean Section, Experience in Northern Borders Saudi Arabia. 2022

3. Zhou L, Sun C, Chen M, He G, Zeng S, Liu X. Wave compression suture: A modified uterus-preserving treatment for placenta previa by reconstruction of the lower uterine segment. Medicine (Baltimore). 2026 Jan 30;105(5):e47468.