B-Lynch uterine compression sutures in the conservative surgical management of uterine atony.

Abstract

AIM:

To evaluate the success rate and possible complications of the B-Lynch uterine compression sutures in women who suffered from postpartum uterine atony unresponsive to medical treatment.

MATERIALS AND METHODS:

A total of 36 women who were managed with the B-Lynch suture, with or without additional surgical procedures following uterine atony unresponsive to medical treatment, were evaluated retrospectively.

RESULTS:

Sixteen women were primarily managed with the B-Lynch compression sutures, and 11 women had the B-Lynch compression sutures following failure of achievement of hemostasis by ligation of uterine artery alone (n = 4), or uterine artery plus uterine branch of ovarian artery (n = 7). Eight women had bilateral internal iliac artery ligation (BIIAL) following failure of achievement of hemostasis by the B-Lynch compression sutures. Two women (5.5%) underwent post-cesarean hysterectomy. The overall success rate of B-Lynch was 75% (27/36), and the overall success rate of B-Lynch plus BIIAL was 94.4% (34/36). Three women were admitted to the intensive care unit. There was no death related to the hemorrhage in our series. No short-term complications such as uterine necrosis, hematometra, pyometra, or uterine erosion related to the uterine compression suture were observed.

CONCLUSION:

Overall success rate of the B-Lynch sutures and B-Lynch sutures plus BIIAL was 75 and 94.4%, respectively. The B-Lynch technique does not necessarily require specific suture material. Uterine devascularization or BIIAL did not increase the risk of the possible short-term complications such as uterine necrosis. In case of failure of the B-Lynch uterine compression sutures, BIIAL may be beneficial to save the uterus.

• Authors: Baris Kaya, Abdullah Tuten, Korkut Daglar, Murat Onkun, Seyhun Sucu, Askin Dogan, Orhan Unal, Onur Guralp
• Journal: Archives of gynecology and obstetrics (Arch Gynecol Obstet) Vol. 291 Issue 5 Pg. 1005-14 (May 2015) ISSN: 1432-0711 [Electronic] Germany
• PMID: 25315382 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adult
• Female
• Hemostasis, Surgical (methods)
• Humans
• Ligation
• Postpartum Hemorrhage (etiology, prevention & control, surgery)
• Pregnancy
• Retrospective Studies
• Suture Techniques
• Sutures
• Treatment Outcome
• Uterine Inertia (physiopathology, surgery)
• Uterus (surgery)