Résumé
Objectives: To assess the efficacy of B-Lynch suture in the management of postpartum hemorrhage
Study Design: Case series report
Study Setting: Department of Obstetrics and Gynecology unit I, Jinnah Hospital, Lahore
Materials and Methods: The data was collected retrospectively from hospital record during July 2003 to June 2004, of patients with PPH in whom B-lynch suture was applied to control hemorrhage. The study included 45 women who were admitted through emergency or out patient department during last one-year period who fulfilled the inclusion criteria. Data was collected according to a pre-set proforma which included age, parity, gestational age, cause of PPH, estimated blood loss, number of transfusions needed and duration of hospital stay and was reviewed and evaluated in terms of treatment outcome, potential side effects and the efficacy of B-Lynch suturing technique as treatment of postpartum hemorrhage. Ratio and proportions were calculated and Chi- square test was used for significant associations
Results: The age of the patients ranged from 2035yrs and parity from 1-6. Gestational age was from 34-41wks. 36 [80%] women had PPH due to uterine atony, while 9 [20%] had PPH due to placental causes, and none of them had bleeding disorders. The estimated blood loss was 1000-1500cc in 15 patients [33.33%], 1500-2000cc in [62.22%] and 2 patients [4.44%] had blood loss more than 2000cc. 15 [33.33%] patients required 3 transfusions, 28 [62.2%] required 4 transfusions and only 2 [4.44%] women required 5 transfusions. Suturing technique has been applied successfully in 44/45 patients with failure rate of 2.22%
Conclusion: The B-Lynch suture is a valuable addition to the surgical treatment of postpartum hemorrhage because of its simplicity of application, relative safety, life saving potential and its capacity for preserving the uterus and thus fertility. Satisfactory haemostasis can be assessed immediately after application
Résumé
Objectives: To determine the prevalence of anemia in the grandmultiparas and compare it with the prevalence of anemia in women of lesser parities
Design: A prospective comparative study in which data was analyzed using p value and tests of significance
Patients and methods: Two thousand two hundred and ninety eight pregnant patients visiting the out patient department of Jinnah Hospital Lahore were evaluated for anemia. Among them 536 were grandmultiparas and 1762 were of lesser parity. Hemoglobin [Hb] percentage in both groups of patients was measured, on this basis anaemia was classified as mild, moderate or severe
Results: There was no significant statistical difference in the prevalence of mild and moderate anemia but severe forms of anemia were found in grandmultiparas as compared to females of lesser parity. Mild anaemia with haemoglobin [Hb] between 10-11 gm/dl was present in 54[10%] patients of group A and 170 [10%] of patients in group B. But the difference between these two groups was not significant statistically [p>0.05]. The patients suffering from moderate anaemia Hb 7-10 gm/dl were 460 [86%] in group A and 1550 [88%] in group B. The difference in moderate anaemia in the two groups was not statistically significant. The prevalence of severe anaemia was however significantly higher [p<0.05] among GMPs. Severe anaemia with Hb <7 gm/dl was present in 21 [4%] patients in group A out of total 536 and in group B out of total 1762 patients 36 [2%] had significant anaemia
Conclusions: Severe forms of anemia in grandmultiparas were due to closely spaced pregnancies, inadequate dietary intake, lack of effective contraception and social aspects