RESUMO
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