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Uterine compression suturing (UCS) is an effective technique for controlling refractory postpartum hemorrhage (PPH); however, it carries a risk of uterine necrosis. We report the case of a 25-year-old primiparous woman who underwent transverse circular suture of the uterus (TCSU) using three sutures for uterine atony during cesarean section, and whose postoperative course was complicated by uterine infection and necrosis. After active conservative treatment failed to improve her condition, the patient ultimately underwent hysterectomy, despite her strong desire for future fertility. This case highlights that the tension and density of sutures should be carefully considered during UCS to minimize the risk of necrosis due to excessive suturing. Early detection of uterine necrosis requires close integration of clinical surveillance and imaging, facilitating timely intervention and improving patient outcomes. Clinical trial number: Not applicable.
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Xiang et al. (2026) studied this question.
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