Abstract

OBJECTIVE: To determine the efficacy of B-lynch suture in the management of massive PPH.
STUDY DESIGN: This was a Case series Study conducted at Gynae/obs unit ii (Emergency/ OT) Civil Hospital Karachi
SUBJECT & METHOD: Thirty five patients presenting in labor room with complaint of excessive bleeding after delivery were admitted while those patients already admitted and delivered and having excessive bleeding were selected according to inclusion criteria. A detailed history was taken and thorough examination was carried out, relevant investigations were done, after diagnosis, patients were treated conservatively. In patients with intractable primary PPH unresponsive to conservative management, B-lynch suture was applied.
RESULTS: Out of thirty five patients B-lynch suture was successful 83% and failure was 17%. Effectiveness of procedure was higher in 25-35 years of age of women while this was less effective in above 35 years of the age i.e. 71.4%. Similarly effectiveness of procedure was 80% and above 80% in booked and unbooked cases respectively while in referral cases this was observed in 50%. Effectiveness of procedure was also similar in multipara in grand multipara women. Effectiveness of procedure was also presented with respect to gestational age, duration of marriage 4.44 2.0, 38.42 1.18 wks., 9.25 4.5 years.
CONCLUSION: Our study concludes that B-lynch brace suture technique is highly successful in 83% of cases while failure rate is only 17%. There were no intra-operative complications and few postoperative complications. In our experience this technique is a safe, highly effective and easy method to stop the bleeding in massive primary PPH due to uterine atony.it is alternative to hysterectomy especially in young women with restoration of future fertility whose obstetric career otherwise prematurely and involuntarily ends.

Key words: Massive Postpartum hemorrhage, B-lynch compression suture, uterine atony