A Prospective Comparative Study between the Efficacy of Uterine Compression Sutures (B-Lynch) and Bilateral Uterine Artery Ligation for the Prevention of Atonic Postpartum Haemorrhage during Caesarean Section in High Risk Women

Abstract

AbstractBackground: In the current study was held to compare the efficacy of uterine compression sutures and bilateral uterine artery ligation for the prevention of atonic postpartum haemorrhage during Caesarean section in high risk women.Aim of the Study: This study Compartive study between the efficacy of uterine compression suture (B-Lynch) and bilateral uterine artery ligation for the prevention of atonic post-partum hemorrhage during caesarean section in high risk women.Patients and Methods: This study was held on one hundred and fifty patients divided in to 3 groups.- Group A: 50 patients would had prophylactic B lynch sutures and prophylactic medical treatment.- Group B: 50 patients would had prophylactic bilateral uterine artery ligation and prophylactic medical treatment.- Group C: 50 patients (control group) would had only pro-phylactic medical treatment.Results: No statically differences between study groups and between study groups and control group as regarding demographic characteristics of the patients.No statically differences between study groups and be-tween study groups and control group as regarding risk factors for atony.No statically difference between study groups as regarding 1st 6 hour postpartum vaginal bleeding but there was signifi-cantly difference between both study groups and control groups p<0.001.NO statically difference between study groups as regarding total blood loss but there was significantly difference between both study groups and control group <0.001. No statically difference between study groups and control as regarding pre-operative hemoglobin and hematocrit level.No statically difference between study groups as regarding post-operative hemoglobin and hematocrit level, but there was statically difference between study groups and control group as regarding post-operative hemoglobin and hematocrit values p<0.001.No statically difference between study groups as regarding 6 hour postoperative pulse, but there was significantly differ-ence between study groups and control group p<0.001.No statically difference between study groups as regarding postoperative complication, but there was significant difference between study groups and control group p<0.001.Setting: This study was held on one hundred and fifty patients from El Sahel teaching hospital at department of obstetrics and gynecology Study design: A Prospective Com-parative study.Conclusion: There is no difference between uterine com-pression suture (B-Lynch) suture and bilateral uterine artery ligation in prevention of postpartum hemorrhage; while both maneuver are effective as a prophylaxis against postpartum hemorrhage as shown by the results of this study. There can significantly reduce blood loss after cesarean section.Our data demonstrated, that uterine compression suture (B-Lynch) and bilateral uterine artery ligation can be used safely to reduce bleeding after CS as there use was not associated with any significant maternal and neonatal side effects.