Serum Antimullerian Hormone Levels in Patients Who Underwent Hayman Suture

Study Overview
=================
Brief Summary
-----------------
From patient charts we will review patients who had undergone cesarean section within the last 6 months and identify those who received a The Hayman uterine compression suture for uterine atony. We will also select patients who delivered a baby without recieving a Hayman suture to create a control group. Patietns will be grouped as Hayman Group if they recevied a Hayman suture during C/S and control group if thay had not recevied a Hayman suture. We will then check patient charts for post-cesarean outpatient clinic visit and select those who received ovarian reserve evaluation via hormones and antral follicle count during the visits. Finally, we are planning to investigate any correlation between Hayman suture and ovarian dysfunction.

Detailed Description
-----------------
Hayman suture is a common technique for uterine compression to stop bleeding due to uterine atony. Hayman described placement of two to four vertical compression sutures from the anterior to posterior uterine wall without hysterectomy. It is usually employed to overcome uterine atoy dıring cesarean section. However, since the technique is relatively new, data on its safety and efficacy arelimited to a few case reports. several complications including cavity obliteration, blood entrapment and infections have been described. However, data regarding the ovarioan function is lacking.

Official Title
-----------------
Serum Antimullerian Hormone Levels in Patients Who Underwent Hayman Suture for Uterine Atony During Cesarean Section

Conditions
-----------------
Uterine Atony With Hemorrhage, Ovarian Dysfunction

Intervention / Treatment
-----------------
* Procedure: The Hayman uterine compression suture.


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: age 18- 40 years no systemic or endocrine diseases patients who had uterine artery ligation due to atony healthy postpartum patients as controls Exclusion Criteria: patients with Polyctsitic over syndrome Pregnancy with IVF or oocyte donation Obese patients patients with previous/present endometriosis

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
-----------------
Female

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Hayman group<br>Who had undergone cesarean section within the last 6 months and received a The Hayman uterine compression suture for uterine atony. | Procedure: The Hayman uterine compression suture.<br>* Hayman suture is a common technique for uterine compression to stop bleeding due to uterine atony. Hayman described placement of two to four vertical compression sutures from the anterior to posterior uterine wall without hysterectomy. It is usually employed to overcome uterine atony during cesarean section.<br>|
| Control<br>Who had undergone cesarean section within the last 6 months and did not experience neither any complication nor any additional intervention | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in anti-mullerian hormone level from baseline (precesarean) to post-cesarean | ng/dl | Before cesarean section and at any follow-up visit within 6 months of cesarean section | 
| Change in follicle stimulating hormone level from baseline (precesarean) to post-cesarean | IU/L | Before cesarean section and at any follow-up visit within 6 months of cesarean section | 
| Change in luteinizing hormone level from baseline (precesarean) to post-cesarean | mU/mL | Before cesarean section and at any follow-up visit within 6 months of cesarean section | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Antral follicle count in the two study groups | number | At any follow-up visit within 6 months of cesarean section | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Cesarean section, Uterine atony, Hayman uterine compression suture, Follicle-stimulating hormone, Luteinizing hormone, Antral follicle count