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

Farzana Latif, Sadia Qadir, Summera Aslam, Mehnaz Gondal, Rai Muhammad Hammad Arif.

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 B- Lynch 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.