Ayesha Khatoon, Syeda Fariha Hasnny, Junaid Ansari.
B-lynch brace sutures for the treatment of major primary post partum haemorrhage: an experience at Abbasi Shaheed Hospital, Karachi.
Med Channel Jan ;17(3):36-8.

Back ground: In developing countries like Pakistan maternal mortality rates are quite high. Primary Post partum hemorrhage is the number 1 leading cause of maternal mortality in Pakistan. Uterine atony is the major cause of Primary post partum haemorrhage (PPH) i.e 75- 90%, followed by placenta previa and genital tract trauma respectively. B-Lynch sutures are a recently devised technique performed to treat refractory post partum hemorrhage. The purpose of our study is to demonstrate the effectiveness of B-Lynch sutures in our patients with major PPH, not responding to conventional Uterotonic treatment. Material and Method: A Prospective observational study was performed during January 2007 till June 2008 at Department of Gynecology and Obstetrics, Abbasi Shaheed Hospital, Karachi. Data was collected for all the women to whom B-Lynch sutures were applied for intractable PPH. Results:B-Lynch suture was applied to 15 patients with primary PPH in our study. Their mean age was 26.6 years; average gestational age at time of delivery was 37.86 weeks. A total of 3505 patients admitted out of which 363 underwent major operations. A total of 2865 deliveries were performed; among them, 126 patients had PPH. Total 31 cases of severe PPH were identified. B-Lynch sutures were applied to 15 patients, 14(93.3%) had effective control of bleeding. One patient (6.6%) failed to respond suture application. Conclusion: B-Lynch technique appears to be an effective procedure with a relatively low morbidity to control persistent severe PPH.

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