Uterine Compression Sutures: Surgical Management of Postpartum Hemorrhage

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 99; no. 3; pp. 502 - 506
• Main Authors: Hayman, R G, Arulkumaran, S, Steer, P J
• Format: Journal Article
• Language: English
• Published: United States The American College of Obstetricians and Gynecologists 01.03.2002
• Subjects: Adult; Female; Humans; Postpartum Hemorrhage - surgery; Pregnancy; Suture Techniques; Sutures
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1016/S0029-7844(01)01643-X

BACKGROUNDIt has been estimated that worldwide, over 125,000 women die of postpartum hemorrhage each year. The traditional management of this condition includes the use of oxytocics, such as oxytocin, ergometrine, and prostaglandins, before proceeding to ligation of the internal iliac arteries and even hysterectomy. The B-Lynch technique is a surgical procedure that may be used to arrest postpartum hemorrhage resulting from uterine atony. CASESThis paper describes simple modifications of this technique that make this procedure less complex to perform. Three clinical case scenarios illustrate the context in which the sutures may be used. CONCLUSIONCompression sutures placed into the postpartum uterus may provide a simple first surgical step to control bleeding when routine oxytocic measures have failed. We suggest that the technique we have described is a simple procedure and should be tried before more complex interventions are used.