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B‐LYNCH SUTURE FOR POSTPARTUM HEMORRHAGE

Ferguson, J. E. II MD; Bourgeois, F. John MD; Underwood, Paul B. Jr MD

Obstetrics

Background: Postpartum hemorrhage is a major contributor to maternal morbidity and mortality. Numerous medical and surgical therapies have been used, but none has been uniformly successful.

Case: Two women with postpartum hemorrhage due to uterine atony after cesarean for twins are presented. Neither responded to medical management. In the first subject, O'Leary uterine artery ligation and utero-ovarian branch ligations were done without benefit. The B-Lynch suture immediately sustained correction of hemorrhage in both subjects. Magnetic resonance imaging and hysterosalpingogram after the first case showed no uterine defects.

Conclusion: The B-Lynch suture might be a valuable addition to the surgical treatment of postpartum hemorrhage due to uterine atony.

Postpartum hemorrhage is a significant contributor to maternal morbidity and is responsible for up to 30% of maternal deaths in developing nations.1 A variety of medical and surgical techniques have been used to control bleeding in postpartum hemorrhage. Recently, the B-Lynch technique, a suture that envelops and compresses the uterus, was described.2 We treated two women with postpartum hemorrhage due to uterine atony after cesareans for twins. The B-Lynch suture immediately controlled bleeding in both cases.

The B-Lynch suture is technically simple and might be a valuable addition to the surgical treatment of postpartum hemorrhage.

Department of Obstetrics and Gynecology, University of Virginia School of Medicine, Charlottesville, Virginia.

Address reprint requests to: J. E. Ferguson, II, MD Department of Obstetrics and Gynecology University Virginia School of Medicine PO Box 10016 Charlottesville, VA 22906 E-mail: jferguson@virginia.edu

Received July 13, 1999. Received in revised form September 10, 1999. Accepted October 1, 1999.

© 2000 The American College of Obstetricians and Gynecologists