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PPH is commonly due to the abnormalities of one or a combination of four basic processes. They are reffered to as the "4Ts’ namely tone (poor uterine contractions), tissue (retained products of conception or blood clots), trauma (to the genital tract) and thrombin (coagulation abnormalities). Uterine atony is the main cause of PPH accounting for about 75-90% of all cases.2 The traditional management of this condition begins with conservative methods such as bimanual uterine compression, medical therapy with uterotonic agents, uterine tamponade with balloons, and occasionally arterial embolisation; the failure of which often mandates surgical intervention. Surgical measures such as ligation of the major pelvic vessels demand a rarely used skill possessed by few registrars. In the event of intractable hemorrhage despite the above measures, hysterectomy is usually the final resort.3

Pereira Suture: an Alternative Compression Suture to Treat Uterine Atony