Lower uterine segment postpartum hemorrhage. management by Cervical Suture, B-Lynch Suture and Foley Balloon (original) (raw)
Related papers
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.
Compression Uterine Sutures Triumph Over Emergency Peripartum Hysterectomy in Intractable Atonic PPH
Journal of Evidence Based Medicine and Healthcare
To study the efficacy and morbidity of uterine compression sutures in the management of intractable severe postpartum haemorrhage. METHOD A prospective study was done at Muzaffarnagar Medical College, Muzaffarnagar from Jan 2012 to June 2015. There were total 6149 deliveries and 1803 (29.4%) caesarean deliveries and 4346 (70.7%) were vaginal deliveries. Uterine compression sutures B-Lynch and modified B-Lynch (Hayman) sutures were applied in eight patients. A Vicryl No. 1 or catgut No. 2 sutures were used in straight round body needle. Patient was placed in modified lithotomy position to assess the compression effect of uterine compression suture. RESULT There were eight uterine compression sutures applied in 6149 deliveries (1:800). Five (62.5%) were applied at the time of caesarean and three (37.5%) were applied after vaginal or assisted vaginal deliveries. Hysterectomy was avoided in seven patients and one patient (12.5%) required hysterectomy for intractable bleeding due to DIC. Blood transfusions were given in all patients. Postoperative period was uneventful and there was no maternal death. CONCLUSION Uterine compression sutures should be considered in case of intractable postpartum haemorrhage (atonic) and it may obviate the need of hysterectomy and other procedures like hypogastric artery ligation, uterine artery/ovarian artery ligation.
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.
B-Lynch Suture in the Management of Postpartum Haemorrhage; a Cross-Sectional Study
Journal of Postgraduate Medical Institute, 2020
Objective: To assess the outcome of B-lynch suture in primary postpartum haemorrhage. Methodology: This cross sectional study was conducted on 38 patients in Obstetrics and Gynaecology unit Lady Reading Hospital Peshawar from January, 2017 to December 2018. Women with primary postpartum haemorrhage who failed to respond to first line medical management were selected with consecutive sampling. B lynch was applied by consultant gynaecologist. Success was assessed in terms of control of bleeding. Failure of the procedure was defined as the need for an invasive intervention to control bleeding. Results: Average age of the patients was 27.55 years + 5.9 SD with a range of 18-38 years. Out of them,14 (35%) women were primipara while 26 (65%) were multipara. Uterine atony was the most frequent cause of PPH. B Lynch was effective to control primary postpartum haemorrhage in 38 (100%) patients. Conclusion: B-Lynch can be recommended for controlling primary postpartum haemorrhage and preserving the uterus.
Human Reproduction, 2007
BACKGROUND: Transmural uterine compression suturing methods are a fertility-preserving alternative in patients with atonic primary postpartum hemorrhage (PPPH), which does not respond to manual compression or drugs. This study evaluated the effectiveness of a modified U-suturing technique in effecting uterine compression in patients with PPPH after Cesarean section. METHODS: U-suture uterine compression was introduced at our hospital at the beginning of 2005. The medical records of patients with PPPH after Cesarean section who had undergone this treatment, and results of a follow-up and questionnaire were evaluated and our experience with this method was reviewed. RESULTS: Between January 2005 and September 2007, seven patients underwent uterine compression with U-sutures after PPPH. In all cases, treatment was successful, the hemorrhage was controlled and the uterus preserved. Normal menstruation patterns returned in the five patients who returned the questionnaire and no surgery related morbidities were noted at the follow-up examinations of six patients. The technique was simple to perform in an emergency situation. CONCLUSIONS: Uterine compression with U-sutures is a highly effective and straightforward emergency procedure which conserves the uterus in these patients.
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...
Uterine Compression Sutures as an Effective Treatment for Postpartum Hemorrhage: Case Series
American Journal of Perinatology Reports, 2011
We evaluated the role of uterine compression sutures as a conservative treatment for postpartum hemorrhage (PPH) after failed medical treatment. We retrospectively reviewed the charts of all patients who delivered between 2003 and 2009 at a single tertiary care center and who underwent uterine compression sutures for PPH. Twelve women had uterine compression sutures for PPH. The mean age of the patients was 36.3 AE 5.2 years. The mean gestational age at delivery was 37.7 AE 2.0 weeks, and the average estimated blood loss was 2.1 AE 1.1 L. The mean procedure time to perform the uterine compression sutures was 9.3 AE 2.8 minutes. The success rate of compression sutures was 92% with only one failure resulting in a hysterectomy. Uterine compression sutures are an effective method for the treatment of PPH, thus avoiding hysterectomy and preserving potential fertility.
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.