East African Health Research Journal

The basis for better health policy and practice

Simulation Training on Uterine Compression Sutures Placement

  • Francisco M. BarakaDepartment of Obstetrics & Gynaecology, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania; Department of Obstetrics & Gynaecology, Sumve Designated District Hospital, Mantare, Mwanza, Tanzania
  • David Hamis MvuntaDepartment of Obstetrics & Gynaecology, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania; Ocean Road Cancer Institute (ORCI), Dar es Salaam, Tanzania.
  • Zainab Hassan YusuphDepartment of Obstetrics & Gynaecology, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
  • Fatemazahra AmijiDepartment of Obstetrics & Gynaecology, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
  • Mubina SuleimanDepartment of Obstetrics & Gynaecology, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
  • Ikrah AbdallahaDepartment of Obstetrics & Gynaecology, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
  • Angela ThomasDepartment of Obstetrics & Gynaecology, Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania; dOcean Road Cancer Institute (ORCI), Dar es Salaam, Tanzania
  • Peter J.T. WangweDepartment of Obstetrics & Gynaecology, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
  • Belinda BalandyaDepartment of Obstetrics & Gynaecology, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
  • Brian A. MuroDepartment of Obstetrics & Gynaecology, School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania

Abstract

Background: Postpartum haemorrhage remains the leading cause of maternal morbidity and mortality worldwide. In PPH, uterine compression sutures (UCS) are effective in managing atony and related conditions. The techniques were seldom applied at Muhimbili National Hospital (MNH) despite uterine atony being the second most common cause of peripartum hysterectomy. Simulation training was done on the UCS techniques.
Objective: To determine the immediate and long-term outcomes of simulation training on UCS placement in the management of PPH.
Methods: Simulation training with uterine mattress models was conducted for the B-Lynch Suture (BLS), Hayman Suture (HS), and Cho-Squire sutures (CSS). In the pre- and post-training phases, participants reported their self-perceived knowledge and attitudes toward applying UCS via Likert-scale questions. The Wilcoxon matched-pairs signed-rank test was used to compare the median score before and after training. A P value of <.05 was considered statistically significant. A follow-up was conducted over the course of one year to assess the application of the techniques, and another year to follow up on the patients.
Results: Sixty-nine doctors participated in the training, with the majority being residents (71.1%). In the pre-training survey, 48.7% of participants reported confidence in surgically managing uterine atony via hysterectomy, 20.3% via UCS, and 26.1% reported being unable to apply any surgical method. The median (range) scores increased from 3 (1-5) to 5 (3-5) (P<.01) from pre- to post-training. B-Lynch and Hayman’s sutures were used in 15 patients over a one-year period. These techniques were effective in 14 (93.3%) patients.
Conclusion: Simulation training in UCS techniques using low-cost uterine models showed significant improvements in self-perceived knowledge, positive attitude, and skills in applying BLS and HS for PPH management (P<.001). It resulted in an abrupt increase in cases of PPH managed by BLS and HS.

Issue
Vol. 10 No. 2 (2026): East African Health Research Journal
Section
Original Articles
Published
2026-11-04
DOI
https://doi.org/10.24248/eahrj.v10i2.344