Successful use of the B-Lynch uterine compression suture in treating intractable postpartum hemorrhage after cesarean delivery in Rajavithi Hospital.

OBJECTIVE To evaluate the effectiveness of the uterine compression suture (B-Lynch and modified B-Lynch suture) in avoiding hysterectomy in cases ofpostpartum hemorrhage and in eliminating the need for surgical intervention to arrest bleeding. MATERIAL AND METHOD This was a retrospective study using data all from women giving birth in Rajavithi Hospital between July 2010 and June 2012. Data were gathered exclusively from the medical records ofpatients who underwent the B-Lynch suture procedure, and details were recorded of risk factors, managements, and outcomes. RESULTS There were 17,692 deliveries during this period with postpartum hemorrhage (PPH) occurring in 4.2% of total vaginal and cesarean deliveries. Of these, the B-Lynch suture procedure was performed in treating postpartum hemorrhage in 24 cases. Hysterectomy could not be avoided in one woman who had excessively prolonged massive bleeding resulting in disseminated intravascular coagulopathy (DIC). The success rate in this study was 95.8% with 95% confidence interval 79.8-99.3. CONCLUSION The present study showed that the B-Lynch suture is an effective and safe surgical option for treatment of intractable postpartum hemorrhage with no apparent adverse outcomes. The procedure should be taught to any physician who deals with parturition and should be applied as standard protocol for the management of PPH in the operating room.