Uterine Wall Partial Thickness Necrosis Following Combined B-Lynch and Cho Square Sutures for the Treatment of Primary Postpartum Hemorrhage

Clinical study of post partum haemorrhage from a teaching hospital in Maharashtra, India

“…Uterine compression suturing (UCS) was recommended as the first-line measure preventing hysterectomy in patients with uterine atony who respond to bimanual compression. 8,15,16 In a recent prospective population-based study, the estimated rate of use of UCS was 18 cases per 100.000 deliveries (95% CI; 15-20 per 100.000); UCS was mostly attempted in women delivering by caesarean section and in only 8.5% of patients delivering vaginally. 8,17 Results of our study are also consistent with the study conducted by Shaikh et al in Hyderabad where 8% of cases were treated with B Lynch.…”

B-Lynch: A Technique for Uterine Conservation or Deformation? A Case Report with Literature Review

“…A case of uterine rupture which occurred at third trimester following B-Lynch suture use has been reported [16]. Similarly, a full thickness myometrial necrosis which occurred in a subsequent pregnancy has also been reported by Akoury et al, This was noticed during caesarean section and it was thought to be caused by compression effect of sutures, which may have led to uterine wall necrosis, both anteriorly and posteriorly [13].…”

“…After this, patient had a full term pregnancy one year later and an area of full thickness myometrial necrosis was noted, which required operative resection. The author concluded that pressure which was produced by the compressive sutures may have caused progressive myometrial necrosis [13]. In our case, B-Lynch suture, followed by bilateral uterine and hypogastric artery ligation was done, to control postpartum haemorrhage.…”

Management of Postpartum Haemorrhage Due to Uterine Anomalies or the Asymmetric Uterus Growth: Two Case Report and Literature Review

“…Uterin duvarda parsiyel defekt, enfeksiyon, uterin sineşiye bağlı parsiyel menstrüasyon engellenmesi, piyometra ve Asherman's sendromu özellikle kare sütür sonrasında saptanmıştır. [15][16][17][18][19] Kompresyon sütüründe anterior ve posterior duvarlar birlikte olduğundan, teorik olarak arada pıhtı ve debris olma ihtimali daha fazladır. Bu sütür sonrası bu alanda kavite kontrolü yapılmalıdır.…”

“…En sık saptanan bulgu uterin sineşidir. 18,19 Bir çalışmada, 11 hastada tek kare sütür kullanılmış ve uzun dönem izlemlerinde ulaşılan 9 hastada menstrüel bir problem olmadığı saptanmıştır. Histerosonografi yapılan 6 hastada endometriyal kavitenin düzenli ve adezyon olmadığı saptanmıştır.…”