SUCCESS RATE OF B-LYNCH SUTURE IN THE TREATMENT OF POSTPARTUM HEMORRHAGE IN WOMEN UNDERGOING EMERGENCY CAESAREAN SECTION

Abstract

Background

: Postpartum hemorrhage is one of the five main causes of maternal mortality with an estimated prevalence of 34% in Pakistan. Uterine atony has been described as the most common underlying cause. Application of B-Lynch suture to prevent atony has been shown to successfully control postpartum hemorrhage in the previous literature. However, all of the existing studies were conducted with a very small sample size and the results were conflicting. So the purpose of this study was to repeat this trial over a larger sample size to confirm the control of PPH with B-Lynch suture in women undergoing emergency cesarean section. The objective of the study was to calculate the frequency of successful control of PPH with B-Lynch sutures in women during emergency cesarean section.

Material and Methods:

This cross-sectional study was conducted in Obstetrics and Gynecology Department, Sir Ganga Ram Hospital, Lahore from 25/11/2020 to 24/05/2021. This study involved 314 patients who underwent emergency cesarean section and developed PPH which was managed by BLynch suture. Informed consent was taken.

Results:

The patient's mean age was 27.46±5.61 years. Most of the patients (n=125, 39.8%) were para 2, then para 3 (30.9%) and para 1 (24.2%) while only 5.1% patients were para 4. Following the application of the B-Lynch suture, PPH was successfully controlled in 301 (95.9%) patients while 13 (4.1%) patients didn’t respond well and were managed by hysterectomy. When data was stratified for age groups, the frequency of successful control of PPH was 96.9% between 20-25 years, 96.0% between 26-30 years, 95.9% between 31-35 years, and 91.9% between 36-40 years of patients age, and it was a statistically insignificant difference (p=.617). When data was stratified for parity, the frequency of successful control of PPH was 94.7% among para 1, 96.0% among para 2, 96.9% among para 3 and 93.8% among para 4, however again the observed difference was statistically insignificant (p=.874).

Conclusion:

B-Lynch suture was found to successfully control postpartum hemorrhage in 95.9% of patients undergoing emergency cesarean section