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Modified anchored B-Lynch uterine compression suture for post partum bleeding with uterine atony.

Research paper by Jeevan P JP Marasinghe, George G Condous, Harshalal R HR Seneviratne, Upali U Marasinghe

Indexed on: 11 Feb '11Published on: 11 Feb '11Published in: Acta Obstetricia et Gynecologica Scandinavica



Abstract

A prospective observational study was performed to evaluate the performance of a modified uterine compression suturing technique for the management of refractory post partum hemorrhage (PPH) at two leading tertiary referral centers in Colombo, Sri Lanka. An modified anchored B-Lynch suture was done in 17 women with PPH due to uterine atony. In 13 of the women (76%), bleeding was arrested and the uterus conserved. Four women (24%) did not respond to the anchored compression sutures, necessitating emergency post partum hysterectomy. Mean age was 31.2 years. Nine of the women (53%) were primiparous and eight (47%) parous. Mean estimated blood loss was 1994 ml (range 1200-3300 ml). This newly modified anchor B-Lynch compression suture appeared effective in controlling about 75% of PPH due to uterine atony, which allowed uterine conservation. This simple modification can provide a first line surgical step to control PPH.