Assessment of Efficacy of Hayman Suture Technique in Management of Intraoperative Atonic Postpartum Hemorrhage (original) (raw)
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The Professional Medical Journal, 2017
ORIGINAL PROF-4113 ABSTRACT… Background: Surgical methods of reduction of bleeding from uterus by inserting compression sutures have been developed to reduce the need for emergency hysterectomy in patients with atonic primary postpartum haemmorhage. Objectives: To determine the efficacy of B-Lynch brace suture in the management of atonic primary postpartum haemmorhage during cesarean section. Study Design: A prospective observational study. Setting: Gynaecology Department, Khyber Teaching Hospital, Peshawar. Period: 1 st January 2016 to 31 st December 2016. Methodology: 14 patients who underwent B-lynch suturing for atonic PPH during cesarean section, nonresponsive to medical line of management. Patient's age, parity, booking status, birth weight of newborn, blood transfusion and effectiveness of procedure was noted. The patients were followed up for 6months for any postprocedural morbidity. Results: In all 14 patients with atonic primary postpartum haemmorhage with failed medical treatment, B-lynch suture was applied. 10(71.42%) belonged to 21-30 years age group. 8(57%) were multiparous and 10(71.42%) were non booked. Birth weight of 9(52.94%) cases was 2-3kg.4-5 units of blood was transfused in 6(42.8%) cases. Most common indication for cesarean section was prolonged labor in 4(28.57%), followed by placental abruption and multiple pregnancy in 3(21.42%) each. Success rate of this procedure was 92.85%. It failed in one patient who ended up in hysterectomy. Patients were followed for 6 months and no postprocedural morbidity was seen. Conclusion: This is a beneficial procedure for surgical treatment of atonic uterus especially in young patients where fertility issues are of concern, and has added advantage of less time of application, less bleeding and lesser skill requirement.
Role of Modified B-lynch Suture in Modern Day Management of Atonic Postpartum Haemorrhage
2008
Aims and Objectives : To evaluate effectiveness of modified B-Lynch suture in controlling atonic PPH. Study and Observations : A prospective study conducted at LTMG Hospital and LTMM College, Sion, Mumbai, a tertiary referral centre. We evaluated 73 cases of atonic PPH over a period of two and half years from May 2004 to Oct. 2006. In 31 patients out of 73 we used modified BLynch suture. Out of these 31 patients five had postoperative pyrexia and three patients had superficial wound gap. There were no major surgical complications. Conclusion : Modified B-Lynch suture was successful in controlling PPH and averting obstetric hysterectomy.
Clinical study consisting of 50 patients of uncontrolled atonic postpartum hemorrhage delivered vaginally or by caesarean sec tion in Govt. Medical College and Hospital, Aurangabad or referred from outside from Sept 2011 to Aug 2013 constituted study group. Patients were subjected to modified B-Lynch suture application when medical line of management failed to control PPH. The test of potential efficacy for B-Lynch suture application was simple bimanual compression of exteriorized uterus. If the later procedure reduced blood loss then modified B-Lynch suture was applied.
Modified Pereira Suture as an Effective Option to Treat Postpartum Hemorrhage due to Uterine Atony
Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia, 2018
Nowadays, postpartum hemorrhage is the major cause of maternal mortality and morbidity worldwide. Uterine atony is its main cause; thus, prophylactic measures, as well as medical and surgical fast approaches, have been developed to manage it. The uterine compression sutures are a possible treatment that preserves the uterus and, consequently, the fertility potential. Bearing that in mind, we report two cases of postpartum hemorrhage after caesarean section, successfully treated with a new modification of Pereira suture - longitudinal and transverse uterine sutures were applied after no response was registered to the first-line therapies. Both women recovered, and the postpartum evaluation revealed a normal uterus with an adequate blood supply, suggesting potential fertility, as described in the literature regarding this kind of therapeutic approach.
BMC pregnancy and childbirth, 2017
Postpartum hemorrhage is the leading cause of maternal death, uterine atony accounts for 75-90% of primary postpartum hemorrhage. The efficacy of the Uterine compression suture in the treatment of atonic postpartum hemorrhage is time-tested and can be said to be almost established.The aim of this study was to assess the role of the Mansoura-VV uterine compression suture as an early intervention in the management of primary atonic postpartum hemorrhage. This prospective observational study included 108 women with primary atonic PPH over a period of 44 months. Uterine atony was diagnosed when the uterus was soft and failed to respond to ordinary ecbolics. Early intervention by Mansoura-VV uterine compression sutures was carried out within 15 min of the second dose of ecobolics and before progressing to any further surgical procedure. Following the Mansoura-VV uterine compression sutures, uterine bleeding was controlled in all except one patient (107/108 cases; 99.07%) who required add...
Introduction: Postpartum Hemorrhage (PPH) in Egypt Especially in Rural Area is still one of the main Causes Responsible For maternal morbidity and mortality. It still needs a radical Solution. Aim Of The Work: Evaluation of Lower Uterine Segment Post Partum Hemorrhage Management by Cervical suture, B-Lynch suture and Foley balloon and to evaluate the efficacy and safety of a novel cervical suturing technique. Patient&Methods: This study included 9860 patients in obstetric department for delivery in Banha teaching hospital. It include 30 pregnant women (primigravide and multigravide) in labour admitted to obstetric ward complaining of (PPH).This study was classified into 3 Groups .Group (I): Ten cases were managed by cervical suture in vaginal delivery with cervical tear and laceration. Group (II): Ten cases were managed by B-Lynch suture 7 of them delivered by CS & 3 of them delivered by vaginal delivery then hysterotomy was done to them. Group (III): Ten cases were managed by Foley balloon after vaginal delivery or caesarian section. Results: The mean (± SD) parity for PPH cases in this study was 1.53±1.13 times with a range of 0–7 times. The group representing primigravidas with postpartum hemorrhage was 43.3% of cases, while the group with parity ranging from 1– 4 was 50% of the PPH cases. Finally the group of cases with parity greater than 4 represented 6.7%. The treatment modalities for PPH applied in Banha teaching hospital included ecbolics, uterine massage and bimanual compression in all cases. Repair of trauma was applied in 33, 3%. Replacement with blood and blood products was done in cases with DIC which represented 3.3%, & hysterectomy was done in 3 cases as a last resort measure. Conclusion and Recommendation: The study added an evidence to confirm the world wide applicability of the cervical suturing as a method to improve the management of lower uterine segment PPH .The technique of that suture is easily learned and its popularization therefore, might be a must.
Experience with surgical options for managing atonic post-partum haemorrhage
Nepal Journal of Obstetrics and Gynaecology, 2008
Aim: To analyse the measures taken for controlling primary Post-partum haemorrhage (PPH). Methods: A hospital based descriptive and retrospective study was carried out from 1st January 2005 to 31st December 2006 in the department of Obstetrics & Gynaecology at KMCTH. All patients of having primary Post-partum haemorrhage were analysed for the treatment they received. Results: There were 15 cases of primary Post-Partum Haemorrhage (PPH) from a total delivery of 700 in the year 2005. 9 cases were solely of atonic post-partum haemorrhage. 2 cases were genital tract injuries, 1 case of retained placenta, 1 case of vulval haematoma and 2 cases were of combined cervical tear and atonic primary post-partum haemorrhage. Atonic post-partum haemorrhage remained most important cause. The most common treatment was use of oxytocic. Surgical procedure bilateral uterine artery ligation was frequently performed in 6 cases but it was not effective as a single procedure. B-Lynch brace suture was appl...
TAJ: Journal of Teachers Association, 2018
Objective: This study evaluated the effectiveness of a modified U-suturing technique in effecting uterine compression in patients with atonic primary postpartum hemorrhage (PPPH), which does not respond to manual compression or drugs. Method: We retrospectively reviewed the charts of all patients who delivered between 2013 and 2015 at Gynae & Obstetrics Department of Rajshahi Medical College Hospital and who underwent uterine compression sutures for PPPH and results of a follow-up and questionnaire were evaluated and our experience with this method was reviewed. Results: Fifty two women had uterine compression U sutures for P PPH. The mean age of the patients was 24±2.2 years. The mean gestational age at delivery was 38.2±2.3 weeks, and the average estimated blood loss was 2.3±2.1 L. The mean procedure time to perform the uterine compression U sutures was 11.5±2.8 minutes. None of the 52 patients required hysterectomy. Conclusion: Uterine compression U-sutures technique is an easily and rapidly applied, effective, simple, safe & life saving method for the treatment of PPPH, thus avoiding hyterectomy and preserving potential fertility.
Incidence, Management and Outcome of Atonic Postpartum Haemorrhage at Tertiary Care Hospital
Aim: To study incidence, management and outcome of atonic postpartum haemorrhage. Methods: Cross sectional study design. Analysis of delivery data of one year at Pravara Rural Hospital. Results: There were 116 cases of atonic PPH. The incidence of atonic PPH was 0.88 percent. Atonic PPH was more in caesarean deliveries as compared to vaginal deliveries. It was more in emergency caesarean sections as compared to elective caesarean. There were 54 cases (46.55%) of mild PPH, who were successfully managed by medical methods. Uterine balloon tamponade was used in those cases who did not respond to medical management (31.89%). Surgical intervention in the form of either B Lynch suture or stepwise devascularisation including internal iliac ligation was performed in 5 cases and obstetric hysterectomy was required in 20 cases. There were two maternal deaths among 116 cases of atonic PPH. Conclusion: Atonic Postpartum haemorrhage is common among high risk pregnancies. Institutional deliveries will help in preventing and managing this complication in a effective manner. Facility Preparedness in all respect will prevent deaths due to atonic PPH. The incidence can be lowered by universal adoption of AMTSL. Wise and prompt decisions regarding use of different modalities or combination of modalities will save lives.