Modified B-Lynch Suture Technique for Prevention of Postpartum Hemorrhage [16R]

Abstract Objective To describe the clinical experience with the B-Lynch technique in the management of postpartum hemorrhage as well as the factors related to the indication of the technique and to present the success rates of the application of the B-Lynch technique. Methods Observational, retrospective, cross-sectional, and analytical study. Patient data was obtained through the study of medical records. The study population comprised of patients who underwent hemostatic suture using the B-Lynch technique, including 104 patients within the period from January 1, 2005, to December 31, 2019. Results Of the total of 104 patients, 82.7% did not present any complications. Blood transfusion and intensive care unit admission were the most prevalent complications, with 13.5% and 15.4%, respectively. Only 1% of the patients had puerperal and surgical site infections. The factors most related to the application of the technique were the presence of previous cesarean section (30.8%), use of oxytocin (16.3%), and preeclampsia (11.6%). Puerperal hysterectomy was performed in 4.8% of the patients due to failure of the method. Conclusion The clinical experience with the B-Lynch technique was satisfactory since it presented few complications, with excellent results in hemorrhagic control. Previous cesarean section, the use of oxytocin, and preeclampsia stood out as factors related to the indication of the application of the technique, and the success rate in controlling postpartum hemorrhage was 95.2%.

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Pengelolaan Anestesi untuk Seksio Sesarea Kehamilan Triplet dengan Skor LAS Intraoperatif 6

Jurnal Anestesi Obstetri Indonesia ◽

10.47507/obstetri.v4i1.56 ◽

2021 ◽

Vol 4 (1) ◽

pp. 35-42

Author(s):

Dewi Yulianti Bisri ◽

Tatang Bisri

Keyword(s):

Caesarean Section ◽

Apgar Score ◽

Postpartum Hemorrhage ◽

Suture Technique ◽

Analog Scale ◽

Triplet Pregnancy ◽

Singleton Pregnancy ◽

Multiple Gestations ◽

Linear Analog ◽

Minute Interval

Triplet (kembar tiga) dan kehamilan kembar yang lebih banyak lagi (higher multiple gestations) dihubungkan dengan peningkatan morbiditas ibu dan anak dibandingkan dengan kehamilan ganda atau kehamilan tunggal. Seksio sesarea adalah rute yang disukai untuk melahirkan pasien dengan kehamilan triplet. Seorang wanita, 31 tahun, G1P0A0 gravida aterm triplet hasil inseminasi, BB 72,5 kg, TB 168 cm, Mallampati 1, tekanan darah 130/90 mmHg, laju nadi 97x/menit, SpO2 100% dengan kanul binasal. Induksi dengan propofol 140 mg, atracurium 35 mg, intubasi dengan pipa endotrakheal no 6,5. Ventilasi mekanik dengan volume tidal 560 mL, laju nafas 12 x per menit, postive end expiratory pressure (PEEP) 5. Rumatan anestesi dengan N2O 40%, sevofluran 1-2 vol%. Analgetik fentanyl 100 ug diberikan setelah bayi lahir. Cairan RL 1500 mL, gelofusin 500 mL. Obat-obat lain: misoprostol 800 mcg perrectal, oxytocin 40 IU, methylergometrine 0,6 mg, asam traneksamat 1 gram, dextrose 40% 25 mL. Bayi ke-1 BB 2650 gr, pada jam 19.1, Apgar score 1 menit dan 5 menit 9, 10, Bayi ke-2 BB 2100 gr, Apgar score 1 menit dan 5 menit 9, 10, Bayi ke-3 BB 1900 gr, Apgar score 1 menit dan 5 menit 9, 10 lahir selang 1 menit. Tidak terjadi hipotensi, dan karena skor linear analog scale (LAS) 4-6 setelah terapi medikal maka dilakukan pengikatan uterus dengan tehnik B-Lynch suture, tidak terjadi postpartum hemorrhage, Hb postoperatif 10 g/dL, hematokrit 29%, tidak dilakukan transfusi darah. Analgetik pascabedah dengan petidin 100 mg dan dexketoprofen 100 mg dilarutkan dalam NaCl 0,9% 500 mL yang diberikan untuk 24 jam. Anesthesia Management for Caesarean Section Triplet Pregnancy with Intraoperative LAS Score 6 Abstract Triplet and higher multiple gestations associated with increase maternal and fetal morbidity compare with twin or singleton pregnancy. Caesarean section is route for delivery patient with triplet gestations. A woman, 31 years, G1P0A0 gravida aterm triplet insemination result, BW 72,5 kg, height 168 cm, Mallampati 1, blood pressure 130/90 mmHg, heart rate 97x/minute, SpO2 100% with canul binasal. Induction anesthesia with propofol 140 mg, atracurium 35 mg, intubated with endotracheal tube no 6,5. Mechanical ventilation with tidal volume 560 mL, respiratory rate 12 x per minutes, postive end expiratory pressure (PEEP) 5. Maintenance anesthesia with N2O 40%, sevoflurane 1-2 vol%. Analgetic fentanyl 100 ug given after baby delivery. Fluids with RL 1500 mL, gelofusin 500 mL. Other drugs are misoprostol 800 mcg perrectal, oxytocine 40 IU, methylergometrine 0.6 mg, tranexamic acid 1 gram, dextrose 40% 25 mL. First baby BW 2650 gr, Apgar score 1 minute and 5 minute 9, 10 at 19.21, second baby BW 2100 gr, Apgar score 1 minute and 5 minute 9, 10, third baby BW 1900 gr, Apgar score 1 minute and 5 minute 9, 10 delivered 1 minute interval. No evidence of hypotension and linear analog scale (LAS) score is 4-6 and so needed uterus binding with B-Lynch suture technique, no evidence of postpartum hemorrhage, postoperative Hb 19 g/dL, hematocrit 29%, no blood transfusion. Postoperative analgesia with petidine 100 mg and dexketoprofen 100 mg in NaCl 0,9% 500 mL for 24 hours.

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A descriptive study on Hayman suture technique to control postpartum hemorrhage

Sri Lanka Journal of Obstetrics and Gynaecology ◽

10.4038/sljog.v34i3.4880 ◽

2012 ◽

Vol 34 (3) ◽

pp. 79 ◽

Cited By ~ 2

Author(s):

Anamika Majumdar ◽

Kallol Mallick ◽

Bipin Vasava ◽

Kanan T Desai ◽

Malati Dalal

Keyword(s):

Postpartum Hemorrhage ◽

Descriptive Study ◽

Suture Technique

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Uterine Compression Suture Versus Cesarean Hysterectomy in Management of Intractable Postpartum Hemorrhage

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.10.11540 ◽

2020 ◽

Vol 103 (10) ◽

pp. 1075-1082

Keyword(s):

Pregnant Women ◽

Surgical Management ◽

Postpartum Hemorrhage ◽

Suture Technique ◽

Cesarean Hysterectomy ◽

Operative Outcomes ◽

Uterine Compression Suture ◽

Compression Suture ◽

Group 2 ◽

Group 1

Background: Postpartum hemorrhage (PPH) is the third leading cause of maternal death. Uterine atony is the most common cause, and surgical management is the last method for PPH. Objective: To assess operative outcomes after uterine compression suture (B-Lynch suture technique) versus cesarean hysterectomy. Materials and Methods: The comparison retrospective research evaluated the operative outcomes of the pregnant women managed by the B-Lynch suture technique (group 1) versus cesarean hysterectomy (group 2). Unique data form, designed to collect all patients involved in the present study, were reviewed and analyzed. The population study was pregnant women divided into two groups. Thirty-five patients were assigned to group 1 and thirty-five patients were assigned to group 2. The independent t-test was used to compare means of categorical variables between the two groups, with p<0.05 indicating statistical significance. Results: Twenty-three thousand two hundred fifty-eight pregnant women delivered during the study period, which was 18 years 6 months. PPH occurred in 563 patients (2.42%), in both vaginal and cesarean deliveries. Intractable PPH occurred in 177 patients (0.76%) during cesarean section. Clinical data risk factors were age, complications while receiving blood transfusion, injury to the urinary bladder, and death. Several outcomes in group 1 were better than in group 2, such as the interval of operation, blood loss, fever after surgery, and saving of life. However, three patients in the trial of B-Lynch suture were changed to hysterectomy due to curative management. Conclusion: The uterine compression suture (the B-Lynch technique) should be used promptly to manage acute PPH due to uterine atony. Additionally, a cesarean hysterectomy might be used for surgical management in the latter method, depending on the severity of the patient, the etiology of PPH, and the obstetrician’s skills and experience. Keywords: Postpartum hemorrhage, Uterine compression suture, Cesarean hysterectomy

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Safety Pin Suture for Management of Atonic Postpartum Hemorrhage

ISRN Obstetrics and Gynecology ◽

10.5402/2012/405795 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Ali Abdelhamed M. Mostfa ◽

Mostafa M. Zaitoun

Keyword(s):

Observational Study ◽

Postpartum Hemorrhage ◽

Medical Management ◽

Suture Technique ◽

Treatment Resistant ◽

Life Threatening ◽

Uterine Compression Suture ◽

Compression Suture ◽

Uterine Fundus ◽

Safety Pin

Objective. To assess the efficacy of a new suture technique in controlling severe resistant uterine atonic postpartum hemorrhage. Patients and Methods. This is a retrospective observational study that included thirteen women with uterine atony and postpartum bleeding that did not react to usual medical management. All these women underwent compressing vertical suture technique in which the anterior and posterior walls of the uterus were attached so as to compress the uterus. The suture is transfixed at the uterine fundus, thus eliminating the risk of sutures sliding off at the uterine fundus (safety pin suture). Results. safety pin uterine compression suture was a sufficient procedure to stop the bleeding immediately in 92.2% of the women. None of the women developed complications related to the procedure. Conclusion. A new safety pin suture is a simple and effective procedure to control bleeding in patients with treatment-resistant, life-threatening atonic postpartum hemorrhage with the advantage of eliminating the risk of the sutures sliding off at the uterine fundus.

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Assessment of Efficacy of Hayman Suture Technique in Management of Intraoperative Atonic Postpartum Hemorrhage

Pakistan Journal Of Neurological Surgery ◽

10.36552/pjns.v24i2.447 ◽

2020 ◽

Vol 24 (2) ◽

Author(s):

DRAKHSHAN NAUMAN ◽

NADIA SAIF ◽

UZMA SIDDIQUE ◽

NOSHEEN NAVEED ◽

UZMA SIDDIQUE

Keyword(s):

Surgical Technique ◽

Observational Study ◽

Study Design ◽

Postpartum Hemorrhage ◽

Medical Management ◽

Maternal Morbidity ◽

Descriptive Study ◽

Suture Technique ◽

Uterine Atony ◽

Maternal Morbidity And Mortality

Objective: To assess the efficacy of the Hayman suture technique in the management of intraoperative atonic postpartum hemorrhage thus reducing maternal morbidity and mortality. Study Design: Simple Descriptive study. Materials and Method: A simple descriptive observational study was conducted at Farooq Hospital and AIT, Lahore. The study included all patients with intraoperative atonic PPH after elective and emergency caesarean sections, during the study period, in whom medical management of PPH failed and Hayman suture was applied. Results: Hayman suture was 97.5% successful in controlling primary PPH due to intraoperative uterine atony. It failed in only one patient (2.5%) and that patient needed a hysterectomy. Conclusion: Hayman suture is an effective and quick technique in controlling primary PPH due to intraoperative uterine atony. It is an effective surgical technique after failure of conservative medical management. It is easy to apply and can be applied by Postgraduate trainees and registrar in emergency as lifesaving procedure.

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