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Failure of B-Lynch Compression Suture in a Patient with Couvelaire Uterus and Uterine Atony
No full textIn this paper, we aimed to discuss the reliability of B-Lynch suture,
especially in patients with Couveliare uterus, and to present a
patient who underwent bilateral uterine artery ligation in addition
to B-Lynch compression suture for uterine atony resulting from
abruptio placentae and developed retroperitoneal hematoma due
to uterine laceration in the postpartum period
B-lynch sütürünün ilerideki fertilite potansiyeli üzerine etkisi
No full textYüksek oranda maternal morbidite ve mortaliteye sahip postpartum kanama kontrolünde kullanılan B-Lynch sütürüne bağlı potansiyel komplikasyonlardan intrauterin sineşi ve tubal oklüzyonun ilerdeki fertilite üzerine etkisinin histerosalpingografi (HSG) ve histeroskopi (H/S) ile postpartum araştırılması. GEREÇ VE YÖNTEM: Aralık 2010- Aralık 2011 tarihleri arası Recep Tayyip Erdoğan Üniversitesi Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum bölümünde doğum sonrası medikal tedaviye yanıt vermeyen ve kan transfüzyon ihtiyacı oluşan erken postpartum kanamalı 8 hastaya B-Lynch sütürü uygulandı. Bu hastalar postpartum 3. aylarında, son menstürel periyotlarının ilk 10 günü içinde çağırıldı. HSG ve H/S ile uterin kavite ve tubal geçiş açısından değerlendirildi. BULGULAR: Çalışmamızda erken postpartum kanamalı hastaların tamamında kanama kontrolü B- Lynch sütürü ile sağlandı. B- Lynch sütürü postpartum kanama kontrolünde histerektomiye alternatif bir metod olarak etkili idi. Hastaların tamamında uterin kavite normaldi, bilateral tubal akım mevcuttu. B- Lynch sütürü fertil çağda olan ve ilerde çocuk istemleri olabilecek bu hastalarda fertilite koruyucu bir alternatif olarak bulundu. SONUÇ: B-Lynch sütürünün postoperatif dönemde kavitede adhezyon ve tubal oklüzyona yol açmadığı görülmüştür. Fertilite isteği olan hastalar için histerektomiye alternatif gü- venli bir metodtur.Yüksek oranda maternal morbidite ve mortaliteye sahip postpartum kanama kontrolünde kullanılan B-Lynch sütürüne bağlı potansiyel komplikasyonlardan intrauterin sineşi ve tubal oklüzyonun ilerdeki fertilite üzerine etkisinin histerosalpingografi (HSG) ve histeroskopi (H/S) ile postpartum araştırılması. GEREÇ VE YÖNTEM: Aralık 2010- Aralık 2011 tarihleri arası Recep Tayyip Erdoğan Üniversitesi Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum bölümünde doğum sonrası medikal tedaviye yanıt vermeyen ve kan transfüzyon ihtiyacı oluşan erken postpartum kanamalı 8 hastaya B-Lynch sütürü uygulandı. Bu hastalar postpartum 3. aylarında, son menstürel periyotlarının ilk 10 günü içinde çağırıldı. HSG ve H/S ile uterin kavite ve tubal geçiş açısından değerlendirildi. BULGULAR: Çalışmamızda erken postpartum kanamalı hastaların tamamında kanama kontrolü B- Lynch sütürü ile sağlandı. B- Lynch sütürü postpartum kanama kontrolünde histerektomiye alternatif bir metod olarak etkili idi. Hastaların tamamında uterin kavite normaldi, bilateral tubal akım mevcuttu. B- Lynch sütürü fertil çağda olan ve ilerde çocuk istemleri olabilecek bu hastalarda fertilite koruyucu bir alternatif olarak bulundu. SONUÇ: B-Lynch sütürünün postoperatif dönemde kavitede adhezyon ve tubal oklüzyona yol açmadığı görülmüştür. Fertilite isteği olan hastalar için histerektomiye alternatif gü- venli bir metodtur
Uterine necrosis in a case of B-Lynch brace suture
Get PDFB Lynch is a conservative surgical procedure for Atonic PPH not responding to medical line of treatment very few complications of this procedure have been reported. We describe B-Lynch suture erosion through the uterine wall identified on 16 day postpartum. A 24 year old primigravida underwent a primary low transverse cesarean section at term indication being primigravida with breach presentation intra-operatively there was torrential blood loss and uterus remained flabby despite treatment with uterotonics drugs delayed absorbable suture was used to place B-Lynch suture for control of the hemorrhage and had sepsis for which she had to undergo obstetric hysterectomy
Effect of B-Lynch Suture: Bleeding Control and Asherman's Syndrome
No full textAim and objective: The study was aimed to investigate possible complications such as intrauterine synechiae following the B-Lynch suture, which was used to control postpartum hemorrhage (PPH).
Materials and methods: Our study included 36 patients, which underwent B-Lynch suture due to PPH from 2013 to 2015.
Results: Asherman's syndrome was found in 3 (8.3%) of 36 patients who participated in the study. Two patients with Asherman's syndrome had a history of placenta accreta and one patient placenta previa.
Conclusion: Compared to procedures that require experiences such as hysterectomy or internal iliac artery ligation, B-Lynch suture is a high-level PPH approach that preserves fertility potential with preventing complications
The Effect of B - Lynch Compression Suture on Fertility Potential
No full textOBJECTIVE: To investigate the potential complications like intrauterine synechia and tubal occlusion following B- lynch suture which was used to control the postpartum hemorrhage.
STUDY DESIGN: Between December 2010 and December 2011 at the Department of Obstetrics and Gynecology, Rize Education and Reseach Hospital, 8 patients underwent B lynch suture for postpartum hemorrhage that was intractable to medical treatment and needed blood transfusion. These patients were called at 3. month of postpartum period. Uterine cavity and tubal patency was evaluated with hysterosalpingography and hysteroscopy.
RESULTS: Early postpartum hemorrhage was controlled with B- lynch suture in all patients. In hysterosalpingographic and hysteroscopic inspection; uterine cavities were normal with bilateral tubal free passages in all patients.
CONCLUSION: B- lynch suture was found to be an effective fertility preserving alternative to emergency postpartum hysterectomy in reproductive age women
Successful Management of Postpartum Hemorrhage Using B-Lynch Suture
No full textBackground:
Postpartum haemorrhage (PPH) is a life threatening obstetric emergency. In Pakistan 25% of maternal deaths are due to PPH and majority is due to uterine atony. B-Lynch suture is a simple and effective method for control of PPH due to uterine atony as an alternative to more complicated surgery including hysterectomy with loss of fertility and associated psychological morbidity.
Objective:
To demonstrate the effectiveness of B-Lynch compression suture in patients with massive postpartum haemorrhage due to uterine atony refractory to medical treatment.
Methods:
Prospective observational study conducted at Sobhraj Maternity Hospital, Karachi, from January 1, 2012 to December 31, 2012. Data was collected during the 12 month period for all women who had massive primary postpartum haemorrhage (> 1500ml) due to uterine atony refractory to uterotonic agents in whom surgical haemostasis was initiated by applying B-Lynch suture. Patients were followed up at 6 weeks, 6 months and 12 months. The main outcomes evaluated were reduction or cessation of bleeding, whether hysterectomy was needed to control haemorrhage and whether minor or major complications of the procedure arose.
Results:
During the 12 months study period 3.1% (152/4782) women had primary postpartum haemorrhage, while massive postpartum haemorrhage occurred in 0.62% (30/4782) cases. Majority of these cases were due to uterine atony (20/30). B-Lynch suture was applied to 16 women who had massive primary postpartum haemorrhage due to uterine atony refractory to uterotonic agents. Effective haemostasis was achieved in all cases. None of the women required hysterectomy. All women later resumed normal menstrual flow without any abnormality. One patient had spontaneous pregnancy after eleven months of her delivery.
Conclusion:
B-Lynch suture is effective in the control of massive postpartum haemorrhage as an alternative to hysterectomy, a lifesaving procedure preserving the uterus and thus fertility.
Key Words:
Massive Postpartum Haemorrhage, B-Lynch Suture, Uterine Atony
B-Lynch uterine compression sutures in the conservative surgical management of uterine atony
No full textOverall success rate of the B-Lynch sutures and B-Lynch sutures plus BIIAL was 75 and 94.4 %, respectively. The B-Lynch technique does not necessarily require specific suture material. Uterine devascularization or BIIAL did not increase the risk of the possible short-term complications such as uterine necrosis. In case of failure of the B-Lynch uterine compression sutures, BIIAL may be beneficial to save the uterus
Effect of b-lynch suture: Bleeding control and asherman’s syndrome
No full text© 2021, Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved.Aim and objective: The study was aimed to investigate possible complications such as intrauterine synechiae following the B-Lynch suture, which was used to control postpartum hemorrhage (PPH). Materials and methods: Our study included 36 patients, which underwent B-Lynch suture due to PPH from 2013 to 2015. Results: Asherman's syndrome was found in 3 (8.3%) of 36 patients who participated in the study. Two patients with Asherman's syndrome had a history of placenta accreta and one patient placenta previa. Conclusion: Compared to procedures that require experiences such as hysterectomy or internal iliac artery ligation, B-Lynch suture is a high-level PPH approach that preserves fertility potential with preventing complications
Uterine necrosis following B Lynch suture: a rare complication
Get PDFThe B-Lynch uterine suture brace is a relatively new technique used for treatment of postpartum haemorrhage. These uterine compression sutures have achieved hemostasis while preserving fertility in many women and thus their efficacy and safety have been time tested. Very few complications have been reported following B Lynch suture. These include Asherman’s syndrome, hematometra, pyometra, localized areas of uterine necrosis and full-thickness defects in the lower uterine segment or uterine fundus and erosion of uterine wall. Herewith, reporting a case of 23-year-old woman who underwent cesarean section for breech presentation. She had atonic PPH for which uterine artery ligation was done along with B-lynch suture. She developed uterine necrosis for which hysterectomy was done. Microsections showed that endometrial cavity was filled with gangrenous slough extending to variable extent in myometrium and cervix.</jats:p
B- Lynch suturing in postpartum haemorrhage management and maternal outcome
Get PDFSurgical care of atonic Postpartum Hemorrhage (PPH) following medically unsuccessful treatment has recently been documented, involving the application of uterine compression sutures over the whole thickness of both uterine walls. In both developing and developed nations, PPH continues to rank among the top 5 causes of maternal death, out of the reported cases 75% to 90% are caused by uterine atony. This study was aimed to monitor the B Lynch suture's effectiveness in treating PPH. A total of 104 females between age of 20 and 45 years who were experiencing PPH and were between 36 and 42 weeks’ gestation were included in the study. Patients with any bleeding disorders, genital hematomas, conception retirements, ruptured uteruses, and genital injuries were not included. Success criteria were tracked, such as bleeding control within 15 minutes of the surgery. The mean age of females was 27.69 ± 3.68 years. There were two different mean gestational ages: 39.98 ± 1.57 weeks and 40.04 ± 1.68 weeks, with 92.30% success rates. Over 104 women who had postpartum hemorrhages during cesarean sections and who did not respond to conservative treatment were treated with B Lynch suturing, there were only eight (7.69%) patients who failed to respond to this approach and underwent hysterectomy. There were no reported cases of uterine necrosis. Furthermore, two patients were reopened for an abdomen rupture. The results showed that the B-Lynch suture had a good success rate in controlling PPH and improving maternal outcomes. When treating unmanageable postpartum bleeding, B-lynch sutures are a simple, safe, easy, and fertility-preserving procedure
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