Uterine Compression Sutures as an Alternative to Hysterectomy for Severe Postpartum Hemorrhage

Abstract

Objective: To assess the use of B-Lynch type uterine compression sutures as an alternative to hysterectomy for severe postpartum hemorrhage (PPH) due to uterine atony.Methods: The use of uterine compression sutures for severe postpartum hemorrhage was reviewed over a 30-month period (January 2000-June 2002) in a tertiary obstetric unit.Results: In 7 cases of uterine atony at the time of Caesarean section, which were unresponsive to all oxytocic agents, a B-Lynch type compression suture was used before resorting to hysterectomy. In 6 of the 7 women, the bleeding was controlled with the suture, while the other required hysterectomy.Conclusion: At the time of writing there were 6 reports in the literature involving a total of 20 women who were successfully treated with this type of compression suture for severe atonic PPH. Our review adds 7 cases and found that the B-Lynch compression suture is easy to apply and should be considered in cases of severe atonic PPH when oxytocic agents fail, and before resorting to hysterectomy.