Triplet pregnancy in a Jehovah's Witness: recombinant human erythropoietin and iron supplementation for minimising the risks of excessive blood loss

Kalu, Emmanuel; Wayne, Christopher; Croucher, Carolyn; Findley, I.; Manyonda, Isaac

doi:10.1111/j.1471-0528.2002.01122.x

Cited by 13 publications

(8 citation statements)

References 12 publications

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“…The prophylactic insertion of the B-Lynch suture in a patient at risk of bleeding was first advocated by B-Lynch ; (unpublished data of 7 cases in 2002) and then by Kalu et al (2002). They inserted a B-Lynch suture in a Jehovah's Witness with a triplet pregnancy at the time of the CS with successful outcome.…”

Section: Methodsmentioning

confidence: 97%

A worldwide review of the uses of the uterine compression suture techniques as alternative to hysterectomy in the management of severe post-partum haemorrhage

El-Hamamy

B-Lynch

2005

Journal of Obstetrics and Gynaecology

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Postpartum haemorrhage (PPH) is a worldwide problem. The historical background dates back to William Smelley's in the seventeenth century in his famous treaty of the theory and practice of midwifery in 1752. Changes in clinical factors and surgical expertise compel the modern day midwife and obstetrician to be vigilant in identifying risk factors and apply appropriate solution early. The recent confidential enquiry into maternal death (why mothers die (2000-2002)) identifies areas of substandard care. The rising caesarean section rate adds to the rising incidence of PPH. The reduction in junior doctor's hours may limit the pool of experienced obstetric surgeons available to manage severe PPH competently. There can be major complications following radical surgery for PPH. These include loss of fertility, other morbidity and even maternal death. The invention of the B-Lynch surgical technique for the conservative management of PPH was first performed and reported by a consultant obstetrician and gynaecological surgeon in Milton Keynes NHS Trust publishing the first series of cases in BJOG 1997. This has made a significant impact on the conservative surgical management of massive PPH. There are now over 1300 successful applications of this technique worldwide (CB-Lynch personal communication). Other similar or modified techniques such as Cho's Square Suture and Haymen's modification of the B-Lynch Suture Technique have been introduced adding to more available methods of conservative surgery. The current list of publications of successful application of the B-Lynch compression technique is encouraging and more outcome data can be reported by a letter or e-mail to enquiries@cblynch.com. Obstetricians and midwives both in developed and underdeveloped countries should seek training and attend fire drills in PPH control to avoid maternal morbidity and death. There should be special concentration on effective conservative surgery such as uterine compression techniques to avoid major morbidity and loss of fertility.

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Section: Methodsmentioning

confidence: 97%

A worldwide review of the uses of the uterine compression suture techniques as alternative to hysterectomy in the management of severe post-partum haemorrhage

El-Hamamy

B-Lynch

2005

Journal of Obstetrics and Gynaecology

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“…The shortcomings of the present study include: (i) the small sample size of our research is a limitation; (ii) a long‐term comparison with other UCS is required; (iii) the suture should be further tested and verified for its prophylactic application in PPH as other authors have validated and analyzed the efficacy of prophylactic B‐Lynch sutures in high‐risk patients, which would be a chance to turn a corner on the therapeutic principles in PPH. We will further explore the role of the suture in the prophylaxis of PPH, hoping to find an effective suturing means to prevent potential PPH.…”

Section: Discussionmentioning

confidence: 99%

Ring compression suture for controlling post‐partum hemorrhage during cesarean section

Zhang

et al. 2018

J of Obstet and Gynaecol

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“… 18 B-Lynch also described in his first report that “cost-effectiveness of this procedure may encourage developing countries to consider its application where necessary both for prophylactic and therapeutic purposes”. Some reports used this technique for prophylaxis in risk cases of postpartum hemorrhage such as Jehovah’s witness with triplets, 19 eclampsia, multiple pregnancy, chorioamnionitis, and prolonged second-stage and uterine atony after delivery. 15…”

Section: Discussionmentioning

confidence: 99%

Uterine flexion suture: modified B-Lynch uterine compression suture for the treatment of uterine atony during cesarean section

Songthamwat¹,

Songthamwat²

2018

IJWH

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ObjectiveThe aim of this study was to report our clinical experience of applying a uterine flexion suture, which was modified from the B-Lynch uterine compression suture, for treating uterine atony during cesarean section.Materials and methodsThis is a retrospective descriptive study describing the use of a new technique, uterine flexion suture, for treating uterine atony during cesarean section. The study period was from January 2009 to December 2017 at Udonthani Hospital, Udonthani, Thailand. Uterine atony during cesarean section was treated by manual compression, intravenous oxytocin, methylergonovine maleate, and prostaglandins and then was observed for 10–15 minutes before applying a uterine flexion suture in the failed medical treatment cases. The patients were observed for vaginal bleeding, hematometra, and infection after operation. Uterine ultrasound scan results on days 1, 7, and 30 postoperation were also reviewed.ResultsFifty-seven patients with uterine atony during cesarean delivery received the uterine flexion suture. The mean age of patients was 27.0 (15–44 years). Thirty-four patients were primipara. The indications for cesarean section were cephalopelvic disproportion in 27 (47.4%) cases, and previous cesarean section in 11 (19.3%) cases. Neither postoperative excessive bleeding nor hysterectomy was observed. There was no hematometra or serious postoperative complication after surgery. The estimated time for uterine flexion suture is only 2–3 minutes and was very easy to perform.ConclusionUterine flexion suture technique, which was modified from the B-Lynch suture, was inexpensive, quick, and effective in the treatment of atonic postpartum uterus in women undergoing cesarean section.

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Triplet pregnancy in a Jehovah's Witness: recombinant human erythropoietin and iron supplementation for minimising the risks of excessive blood loss

Cited by 13 publications

References 12 publications

A worldwide review of the uses of the uterine compression suture techniques as alternative to hysterectomy in the management of severe post-partum haemorrhage

A worldwide review of the uses of the uterine compression suture techniques as alternative to hysterectomy in the management of severe post-partum haemorrhage

Ring compression suture for controlling post‐partum hemorrhage during cesarean section

Uterine flexion suture: modified B-Lynch uterine compression suture for the treatment of uterine atony during cesarean section

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