PRIMARY ATONIC POSTPARTUM HAEMORRHAGE (PPH)

CONSERVATIVE SURGICAL APPROACH

Abstract

Excessive bleeding after childbirth is a major cause of
compression maternal morbidity and mortality in both industrialized and non industrialized countries. Role of
(B-lynch) suture in this context is new in the management of serious postpartum atonic uterine hemorrhage and
needed to be studied. Design: Prospective. Period: From Jan 2002 to June 2003. Setting: Obstetrics &
Gynaecology Unit-I, Allied Hospital Faisalabad (affiliated with PMC). Patients & Methods: All patients with
primary atonic PPH during this period were included where conventional oxytocin had proved ineffective. A
simple suture technique B-lynch (brace suture) was used to preserve future fertility. Results: Total 8 cases of
serious PPH were managed by simple B-lynch suture. Satisfactory hemostasis was achieved in seven cases and
in one patient hysterectomy was done to control hemorrhage. Conclusion: Compression suture placed into the
postpartum uterus may provide a simple first surgical step to control bleeding when routine oxytocin measure
have failed.