-Lynch suture is effective in controlling postpartum hemorrhage: a prospective observational study

Abstract

Postpartum hemorrhage is the most common form of obstetric hemorrhage and is the leading cause of maternal morbidity and mortality in the world The commonest cause of postpartum hemorrhage is uterine atony. It is a serious obstetrical problem and contributes to 25-43% of all maternal deaths in the developing countries. This suture technique was described by Christopher B-Lynch in 1997 that envelope and compresses the uterus to control life-threatening postpartum hemorrhage. Purpose: To study the effectiveness of B-Lynch uterine compression sutures in the control of PPH. Materials: study includes 30 patients whom developed severe atonic PPH not responsive to pharmacological measures at department of Obstetrics and Gynecology at Aswan University hospital, in the period between March 2018 and December 2019. Methods: A prospective observational study, a total of 30 cases of B-Lynch was performed and results analyzed. Results: The procedure was successful in most of the studied cases (86.7%), as no hysterectomy had been done in these patients. On the other hand 13.3% of the studied women had hysterectomy The causative factors accounting for PPH were Placenta previa (43.1%), followed by Abruptio placenta (23.3%) and prolonged/obstructed labour (13.3%) seventy percent of the studied patients (70.0%) had blood loss in the range 1000-1500 ml, whereas 6.7% had a blood loss of more than 2500 ml Slightly more than one quarter of the studied patients (26.8%) did not need any blood transfusion, whereas one third of the patients (33.2%) required one unit and 20.0% of them needed ≥ 3units blood transfusion. Conclusion: The application of B lynch suture is was a very effective method to control primary postpartum hemorrhage. It is was a simple suture and technique of application could be learned by every doctor with little practice .The suture can be used to conserve uterus, with little cost of procedure.