ABSTRACT
Background: Primary postpartum hemorrhage (PPH) due to atonicity during lower segment cesarean section is commonly seen in obstetric practice. Usually, it responds to uterotonics but at times it may lead to life-threatening complications. B-Lynch brace suture is a fertility-preserving alternative surgical technique used in patients with primary atonic PPH not responding to uterotonics. This study was conducted to find out the efficacy of B-Lynch sutures in the surgical management of atonic PPH and prevention of obstetric hysterectomy in the same patients. Materials and Methods: The study included 34 patients with primary atonic PPH during cesarean section refractory to oxytocics and managed with B-Lynch brace sutures. It was a cross-sectional observational study conducted over 1 year at a tertiary hospital. The amount of blood loss, any additional surgical procedure required, and associated complications were studied in these patients. Results: Fertility could be preserved in 100% of the patients undergoing B-Lynch sutures for primary atonic PPH, following the failure of the medical line of management. No major complications including uterine wall necrosis or pyometra were observed in any of these patients. Conclusion: B-Lynch suture is a safe, effective, simple, life-saving, and fertility-preserving surgical technique in the treatment of primary PPH that requires lesser expertise. So it can easily be used before major interventions such as uterine devascularization or obstetric hysterectomy.