Prophylactic B-lynch suture during elective cesarean section in high risk cases of postpartum hemorrhage

ABSTRACT

This study was aiming at comparing prophylactic B-Lynch suture and classic ecbolics during elective cesarean section [CS] in high risk patients for postpartum hemorrhage. This is a prospective randomized controlled study which was conducted at Sohag University Hospital during the period from July 2005 to April 2007. Twenty three patients with a valid indication for elective CS, who have one or more risk factors for postpartum hemorrhage such as placenta previa, repeated CS, or previous history of postpartum hemorrhage, were recruited. Patients were randomly allocated into two groups. Group A [12 patients] was subjected to B-Lynch suture during their elective CS, and group B [11 patients] received classic ecbolics such as IV oxytocin and rectal prostaglandins El analogue [Misopristol 200 mcg tab.]. Both groups were compared regarding intra- and postoperative blood loss, need for blood transfusion, maternal and neonatal morbidities and mortalities. Both groups were similar with regard to the indication of elective CS, risk factors for postpartum hemorrhage, and preoperative hemoglobin level. Intraoperative blood loss and the need for blood transfusion was significantly higher in group B compared to group A. Also, postoperative blood loss through the weight of a special disposable bed linen was significantly higher in group B than in group A in the first 24 hours. Only one patient in group B had subtotal hysterectomy secondary to severe uncontrollable postpartum hemorrhage. All women underwent C.S. with B-lynch in group A were menstruated and one pregnancy occurred at the end of a year of follow up. B-Lynch suture is an appropriate prophylactic technique [safe, effective, and simple] during elective caesarean section in women with potential high risk of developing postpartum hemorrhage