44 results on '"B-Lynch"'
Search Results
2. To B or not to B: the application of uterine compression sutures to reduce blood loss after myomectomy.
- Author
-
Bosilah, Almandouh H., Hussein, Mohamed, Alboghdady, Mahmoud Abdelwahed, Zaky, Ahmed, Almorsy, Ahmed Shafik, Taha, Wael Soliman, Abd El Azeem, Mohammed Farouk, Sholkamy, Amr Mohamed, Elatief Khafagy, Wael Abd, Abdelmoaty, Muhamed Ahmed, Abo Eldahab, Ibrahim Mohamed, Elmohamady Mohamed, Bahaa Eldin, Said Diab, Yasser Mohamed, Mohammed, Ahmed Hashim, Hamid Shaaban, Ahmed Samir, Taha, Elsayed Mohammad, Elboghdady, Adel Aly, Sileem, Sileem Ahmed, Essawy, Hany Gaber, and Elshahat, Elmetwally Farouk
- Subjects
- *
UTERINE artery , *BLOOD loss estimation , *MYOMECTOMY - Abstract
Introduction: The aim was to assess the hemostatic impact of B-Lynch sutures following an open myomectomy for efficacy. Material and methods: In this prospective clinical research, performed in Alazhar university hospitals (Al-Hussain, Damietta, Assiut) and Minia University Maternity Hospital, 250 women scheduled for open myomectomy between January 2021 and January 2023 had multiple fibroid uteri with uterine sizes corresponding to 12-22 weeks. There were two groups of women. Group I (125) underwent standard open myomectomy surgery, whereas Group II (125) underwent normal open laparotomy surgery followed by B-Lynch sutures. Certain inclusion and exclusion criteria were applied to every patient. We recorded vital data, length of the procedure, complications (bleeding during the procedure, bleeding from multiple bites, bladder injury, fever, wound infection), complete blood count before and after surgery, need for blood transfusion, postoperative vital data, time until ambulation, passing flatus, and ability to eat and drink, as well as the amount of blood lost during and after the procedure. Results: There was no statistically significant difference between the two groups in age, parity, weight, number of fibroids, or uterine size as measured by ultrasonography. Between groups I and II, there was a significant difference in the average intraoperative blood loss (Group I lost 562.6 ml, whereas Group II lost 411.3 ml) as well as the mean blood loss following surgery (205 ±82 ml in Group I and 117 ±41 ml in Group II). No significant difference was observed in the mean length of hospital stay between groups I and II (2 ±0.3 days and 2 ±0.6 days, respectively). Conclusions: Using a B-Lynch suture can help minimize blood loss during and after an open myomectomy. Therefore, if the uterus is large and has a lot of fibroids, it is recommended to be done frequently. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
3. Comparison of H‐Hayman uterine compression suture with conventional vertical sutures: A cross‐sectional study in a tertiary center.
- Author
-
Denizli, Ramazan, Farısoğulları, Nihat, Sakcak, Bedri, Özkavak, Osman Onur, Kara, Özgür, Tanaçan, Atakan, and Şahin, Dilek
- Subjects
- *
BLOOD loss estimation , *CESAREAN section , *RED blood cell transfusion , *UTERINE artery , *SUTURES , *SUTURING , *CROSS-sectional method - Abstract
Objective: To compare H‐Hayman, a modified uterine compression suturing technique (UCS) that we describe for the first time in the literature, with conventional vertical UCS techniques. Methods: The H‐Hayman technique was used in 14 women and the conventional UCS technique in 21 women. In order to provide standardization in the study, only patients who had developed upper‐segment atony during cesarean section were recruited for the study. Results: Bleeding control was achieved in 85.7% (12/14) of the cases using the H‐Hayman technique. In the remaining two patients with persistent hemorrhage in this group, bleeding control was provided with bilateral uterine artery ligation, and a hysterectomy was avoided in all cases. With the conventional technique, bleeding control was achieved in 76.1% (16/21) of the patients, and the overall success rate was 95.2% after bilateral uterine artery ligation in those with persistent hemorrhage. In addition, the estimated blood loss and the need for erythrocyte suspension transfusion were significantly lower in the H‐Hayman group (P = 0.01 and P = 0.04, respectively). Conclusion: We found the H‐Hayman technique to be at least as successful as conventional UCS. In addition, patients who underwent suturing with the H‐Hayman technique had less blood loss and a lower requirement for erythrocyte suspension transfusion. Synopsis: The H‐Hayman technique is at least as successful as conventional uterine compression suture techniques. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
4. Antenatal Diagnosis, Surgical Approach and Maternal Morbidity with Placenta Accreta
- Author
-
Nadia Arif, Bushra Zafar, Raja Qaseem Ahmed, and Farrukh Shehzad
- Subjects
B-lynch ,Morbid placental adherence ,Obstetrical hysterectomy ,Placenta accrete ,Medicine ,Medicine (General) ,R5-920 - Abstract
Objective: To emphasize the importance of antenatal diagnosis of the morbidly adherent placenta, employ management options accordingly and their impact on the patient’s outcome. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Okara Pakistan, Jan 2018 to Aug 2020. Methodology: One hundred and twenty-four patients were enrolled in the study. Diagnosed morbidly adherent placenta was made through trans-abdominal ultrasound, and a Doppler study in selected cases of posterior placenta previa magnetic resonance imaging (MRI) was performed. The surgical approach was either a high transverse placenta sparing or a classical incision on the uterus. After delivery of baby, conservative management included resection of part of uterus with adherent placenta followed by reconstruction of the lower uterine segment, segmental resection of myometrial tissue and hemostatic sutures, and over sewing of placental bed. The requirement of blood transfusion, intensive care unit stay, post-operative recovery, and day of discharge, along with all demographic and surgical details, was noted. Results: In 87(70%) patients, high transverse or placental sparing incision was made to assess the baby. Over sewing of the placental bed was done in 37(29.8%) patients, and myometrial segment resection was done in 57(46%) patients. An obstetrical hysterectomy was carried out in 30 patients. Blood transfusion of > 4 units RCCs was required in 92(74%) patients. 16% the patients required intensive care management. Conclusion: Antenatal diagnosis of morbidly adherent placenta through useful imaging modality allowed for a planned surgical approach and minimized......
- Published
- 2022
- Full Text
- View/download PDF
5. Alternative suture tightening technique for achieving adequate suture tension during B‐Lynch compression suture.
- Author
-
Ramly, Fathi and Mohd Kasim, Norhana
- Subjects
- *
SUTURING , *SUTURES , *POSTPARTUM hemorrhage - Abstract
An alternate pull‐on‐compress and pull‐on‐release suture tightening technique can be considered when a surgeon encounters difficulty when performing B‐Lynch compression suture. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
6. Obstetrical outcome after B-Lynch sutures and ligation of uterine arteries: A case report
- Author
-
S. Vanwinkel, L. Claes, and T. Van den Bosch
- Subjects
Postpartum haemorrhage ,B-Lynch ,Uterine artery ligation ,3D ultrasound ,Case report ,Surgery ,RD1-811 ,Gynecology and obstetrics ,RG1-991 - Abstract
Objective: To illustrate the obstetrical outcome after B-Lynch sutures and ligation of the uterine arteries. Case: A 26-year-old nulliparous woman. A caesarean section performed for obstructed labour was complicated by uterine atony. A B-Lynch uterine compression suture technique was used combined with ligation of the ascending branches of the uterine arteries. Before the subsequent fertility treatment, gel instillation sonography and power Doppler imaging showed a normal uterine cavity and restored myometrial vascularization. Subsequent caesarean section showed external adhesions on the anterior uterine serosa. A healthy baby of normal weight was delivered. There was focal placenta accreta; the underlying myometrium was strikingly thinner and prone to inversion. Discussion: After B-Lynch sutures and ligation of the ascending branches of the uterine arteries, the pregnancy was subsequently uncomplicated. The potential association between B-Lynch sutures and placenta accreta or uterine inversion in a subsequent pregnancy has to be assessed in further studies. This case report illustrates how 3D gel instillation sonography is a valuable tool to evaluate the integrity of the uterine cavity.
- Published
- 2021
- Full Text
- View/download PDF
7. New dedicated blunt straight needles and sutures for uterine compression sutures: a retrospective study and literature review
- Author
-
Shinya Matsuzaki, Masayuki Endo, Takuji Tomimatsu, Satoshi Nakagawa, Satoko Matsuzaki, Tatsuya Miyake, Tsuyoshi Takiuchi, Aiko Kakigano, Kazuya Mimura, Yutaka Ueda, and Tadashi Kimura
- Subjects
Uterine compression suture ,Needle ,Blunt ,B-Lynch ,Hayman suture ,Surgery ,RD1-811 - Abstract
Abstract Background We developed a dedicated blunt straight needle with No. 2 polydioxanone sutures (2-Monodiox®) for uterine compression sutures (UCSs) and aimed to assess the outcomes and complication rates of UCSs for postpartum hemorrhage by comparing with commercially available needle and suture types. Methods A retrospective analysis was performed between January 2010 and February 2018. During the study period, two types of commercially available sutures and 2-Monodiox® were used. PubMed, MEDLINE, and Scopus databases were searched for English articles published between January 1997 and May 2017 using search terms related to the suture and needle types for UCSs to discuss the dedicated needles and sutures for UCS. Results The analysis included 47 cases of UCSs for the uterine body with three suture types (No. 0 polydioxanone, 7 cases; No. 1 poliglecaprone 25, 21 cases; and No. 2 polydioxanone, 19 cases). B-Lynch suture using No. 0 sutures was associated with a significantly lower uterine preservation rate than those with Nos. 1 and 2 sutures (42.9% vs. 95.2 and 89.5%, respectively; p
- Published
- 2019
- Full Text
- View/download PDF
8. Uterine flexion suture: modified B-Lynch uterine compression suture for the treatment of uterine atony during cesarean section
- Author
-
Songthamwat S and Songthamwat M
- Subjects
B-Lynch ,uterine atony ,cesarean section ,uterine compression suture ,uterine flexion suture. ,Gynecology and obstetrics ,RG1-991 - Abstract
Srisuda Songthamwat, Metha Songthamwat Department of Obstetrics and Gynecology, Udonthani Hospital, Udonthani, Thailand Objective: The aim of this study was to report our clinical experience of applying a uterine flexion suture, which was modified from the B-Lynch uterine compression suture, for treating uterine atony during cesarean section. Materials and methods: This is a retrospective descriptive study describing the use of a new technique, uterine flexion suture, for treating uterine atony during cesarean section. The study period was from January 2009 to December 2017 at Udonthani Hospital, Udonthani, Thailand. Uterine atony during cesarean section was treated by manual compression, intravenous oxytocin, methylergonovine maleate, and prostaglandins and then was observed for 10–15 minutes before applying a uterine flexion suture in the failed medical treatment cases. The patients were observed for vaginal bleeding, hematometra, and infection after operation. Uterine ultrasound scan results on days 1, 7, and 30 postoperation were also reviewed. Results: Fifty-seven patients with uterine atony during cesarean delivery received the uterine flexion suture. The mean age of patients was 27.0 (15–44 years). Thirty-four patients were primipara. The indications for cesarean section were cephalopelvic disproportion in 27 (47.4%) cases, and previous cesarean section in 11 (19.3%) cases. Neither postoperative excessive bleeding nor hysterectomy was observed. There was no hematometra or serious postoperative complication after surgery. The estimated time for uterine flexion suture is only 2–3 minutes and was very easy to perform. Conclusion: Uterine flexion suture technique, which was modified from the B-Lynch suture, was inexpensive, quick, and effective in the treatment of atonic postpartum uterus in women undergoing cesarean section. Keywords: B-Lynch, uterine atony, cesarean section, uterine compression suture, uterine flexion suture
- Published
- 2018
9. Challenges and diagnosis in therapy of secondary amenorrhoea in caesarean section patient with postpartum haemorrhage B-lynch sutures: a case report.
- Author
-
Harzif AK, Nurbaeti P, Andyra AF, and Wiweko B
- Abstract
Introduction and Importance: International Federation of Gynecology and Obstetrics (FIGO) and WHO report the incidence of postpartum haemorrhage (PPH) reaches 1-10% and contributes to an increase in postpartum maternal mortality with uterine atony as the most common cause. B-Lynch method is a suturing technique to overcome PPH. Although this method has proven useful as an emergency life-saving measure, the post-procedure complications are still able to occur., Presentation of Case: The patient was not menstruating for 14 months after giving birth through caesarean section with B-Lynch due to PPH. Before pregnancy, she had regular menstruation cycle and normal menstrual duration. Her general and gynaecological status were normal. Ultrasound showed the impression of uterine hypoplasia and endometrium that were difficult to assess while both ovaries were normal. Diagnostic hysteroscopy showed a severe degree of Asherman's syndrome. The results of FSH, LH and estradiol were normal., Discussion: B-lynch suture is performed as a method to stop PPH in uterine atony. Secondary amenorrhoea occurs as a complication of B-lynch. Compression action of B-lynch can cause progressive myometrium necrosis resulting in synechiae and blockade of uterine blood flow. This will interfere with the development of the uterus. Intrauterine adhesions and amenorrhoea with normal levels of FSH, LH, and estradiol support the diagnosis of Asherman's syndrome., Conclusion: This case shows that the B-Lynch procedure, which is the worldwide recommended method for treating postpartum haemorrhage due to its high success rate, can cause complications of Asherman's syndrome and cause secondary amenorrhoea., Competing Interests: The authors declare that they have no conflict of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2023
- Full Text
- View/download PDF
10. ATONIC PRIMARY POSTPARTUM HAEMORRHAGE; THE EFFICACY OF B-LYNCH SUTURE IN MANAGEMENT DURING CESAREAN SECTION.
- Author
-
Qadir, Maimoona and Amir, Sohail
- Subjects
- *
HEMORRHAGE , *CESAREAN section , *SUTURES - Abstract
Background: Surgical methods of reduction of bleeding from uterus by inserting compression sutures have been developed to reduce the need for emergency hysterectomy in patients with atonic primary postpartum haemmorhage. Objectives: To determine the efficacy of B-Lynch brace suture in the management of atonic primary postpartum haemmorhage during cesarean section. Study Design: A prospective observational study. Setting: Gynaecology Department, Khyber Teaching Hospital, Peshawar. Period: 1st January 2016 to 31st December 2016. Methodology: 14 patients who underwent B-lynch suturing for atonic PPH during cesarean section, nonresponsive to medical line of management. Patient's age, parity, booking status, birth weight of newborn, blood transfusion and effectiveness of procedure was noted. The patients were followed up for 6months for any postprocedural morbidity. Results: In all 14 patients with atonic primary postpartum haemmorhage with failed medical treatment, B-lynch suture was applied. 10(71.42%) belonged to 21-30 years age group. 8(57%) were multiparous and 10(71.42%) were non booked. Birth weight of 9(52.94%) cases was 2-3kg.4-5 units of blood was transfused in 6(42.8%) cases. Most common indication for cesarean section was prolonged labor in 4(28.57%), followed by placental abruption and multiple pregnancy in 3(21.42%) each. Success rate of this procedure was 92.85%. It failed in one patient who ended up in hysterectomy. Patients were followed for 6 months and no postprocedural morbidity was seen. Conclusion: This is a beneficial procedure for surgical treatment of atonic uterus especially in young patients where fertility issues are of concern, and has added advantage of less time of application, less bleeding and lesser skill requirement. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
11. Failure of B-Lynch Compression Suture in a Patient with Couvelaire Uterus and Uterine Atony
- Author
-
Pınar Çilesiz Göksedef and Mushviqe Hasanova
- Subjects
B-Lynch ,compression suture ,couvelaire uterus atony ,Medicine ,Medicine (General) ,R5-920 - Abstract
In this paper, we aimed to discuss the reliability of B-Lynch suture, especially in patients with Couveliare uterus, and to present a patient who underwent bilateral uterine artery ligation in addition to B-Lynch compression suture for uterine atony resulting from abruptio placentae and developed retroperitoneal hematoma due to uterine laceration in the postpartum period.
- Published
- 2016
- Full Text
- View/download PDF
12. The impact of Bakri balloon tamponade on the rate of postpartum hysterectomy for uterine atony.
- Author
-
Lo, Anderson, St. Marie, Peter, Yadav, Parul, Belisle, Elizabeth, and Markenson, Glenn
- Subjects
- *
UTERINE diseases , *HYSTERECTOMY , *POSTNATAL care , *UTERINE artery , *THERAPEUTIC embolization , *CHI-squared test , *HEMORRHAGE treatment , *LABOR complications (Obstetrics) , *SURGICAL hemostasis , *UTERINE contraction , *COMPARATIVE studies , *DELIVERY (Obstetrics) , *HEMORRHAGE , *RESEARCH methodology , *MEDICAL cooperation , *PUERPERAL disorders , *PUERPERIUM , *RESEARCH , *EVALUATION research , *RETROSPECTIVE studies , *EQUIPMENT & supplies , *THERAPEUTICS - Abstract
Objective: Our objective was to evaluate the impact of uterine tamponade with a Bakri balloon on the rate of postpartum hysterectomy due to uterine atony.Methods: We performed a retrospective cohort study of all deliveries >20 weeks gestation from January 2002 to March 2013 at Baystate Medical Center. Charts were reviewed to determine incidence of postpartum hysterectomy, Bakri balloon placement, uterine artery embolization (UAE) and the B-Lynch procedure. Patients with evidence of placenta accreta were excluded. The primary outcome was the change in rates of postpartum hysterectomy for uterine atony before and after the introduction of Bakri balloon tamponade, using chi-square testing.Results: There were 48 767 deliveries during the study period, with 17 950 before and 30 817 after the introduction of the Bakri balloon. A total of 43 Bakri balloons were placed during the study period and 21 hysterectomies were performed for postpartum hemorrhage secondary to uterine atony, 14 before and 7 after the introduction of the Bakri balloon. This was consistent with a decrease in the rate of postpartum hysterectomy from 7.8/10 000 deliveries to 2.3/10 000 deliveries (p = 0.01).Conclusion: Our findings show that utilization of the Bakri balloon is associated with a decreased rate of postpartum hysterectomy. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
13. A commentary on A new removable uterine compression by a brace suture in the management of severe postpartum hemorrhage
- Author
-
Shigeki eMatsubara, Hironori eTakahashi, and Alan eLefor
- Subjects
Postpartum Hemorrhage ,Uterine atony ,Uterine compression suture ,B-Lynch ,removable suture ,Surgery ,RD1-811 - Published
- 2015
- Full Text
- View/download PDF
14. Uterine salvage management for atonic postpartum hemorrhage using "modified lynch suture".
- Author
-
El-Sokkary, M., Wahba, K., and El-Shahawy, Y.
- Subjects
- *
UTERINE diseases , *PUERPERAL disorders , *HEMORRHAGE , *HYSTERECTOMY , *UTERINE artery , *ARTERIAL surgery , *UTERINE surgery , *CESAREAN section , *COMPARATIVE studies , *LABOR complications (Obstetrics) , *LIGATURE (Surgery) , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *SUTURES , *SUTURING , *UTERUS , *UTERINE contraction , *EVALUATION research , *TREATMENT effectiveness , *SALVAGE therapy - Abstract
Background: To assess the effectiveness of the new modified technique in order to control bleeding in women presenting with atonic, flabby uterus compared to the most commonly described technique of classic B-Lynch suture.Method: This study included 160 women of uncontrolled atonic postpartum hemorrhage delivered by cesarean section at Ain Shams University Maternity Hospital between January 2013 and October 2015. Participants were randomly assigned following simple randomization procedures (computerized random numbers) and divided into two groups. Group, I (80 patients) operated upon by the modified (new technique) stitch while group II (80 patients) operated upon by the classic technique. The ultimate goals were to stop blood loss after placement of the sutures and avoid life-saving hysterectomy thus preserving the life and fertility of the patient.Results: The modified new technique was done in 80 patients with atonic postpartum hemorrhage and it was found to be superior to the classic technique with a success rate 95 % (4 cases needed hysterectomy as a lifesaving measure) compared to 85 % with the classic technique (in 12 cases, a life-saving hysterectomy was done).Conclusions: This technique can replace the classic B-lynch in flabby unresponsive atonic uteri as it has 8 shaped placement of the stitch which causes more firm compression on the uterus and simultaneous bilateral uterine artery ligation. This technique was proved valuable and successful in many patients who suffer from uncontrolled massive postpartum hemorrhage (PPH). [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
15. Obstetrical outcome after B-Lynch sutures and ligation of uterine arteries: A case report
- Author
-
L. Claes, T. Van den Bosch, and S. Vanwinkel
- Subjects
medicine.medical_specialty ,RD1-811 ,Placenta accreta ,medicine.medical_treatment ,Uterine artery ligation ,B-Lynch ,Article ,Postpartum haemorrhage ,03 medical and health sciences ,0302 clinical medicine ,Case report ,medicine ,Caesarean section ,030212 general & internal medicine ,030219 obstetrics & reproductive medicine ,Obstructed labour ,business.industry ,3D ultrasound ,Myometrium ,Obstetrics and Gynecology ,Uterine inversion ,Gynecology and obstetrics ,medicine.disease ,Surgery ,Uterine atony ,medicine.anatomical_structure ,RG1-991 ,Uterine cavity ,business ,Ligation - Abstract
Objective To illustrate the obstetrical outcome after B-Lynch sutures and ligation of the uterine arteries. Case A 26-year-old nulliparous woman. A caesarean section performed for obstructed labour was complicated by uterine atony. A B-Lynch uterine compression suture technique was used combined with ligation of the ascending branches of the uterine arteries. Before the subsequent fertility treatment, gel instillation sonography and power Doppler imaging showed a normal uterine cavity and restored myometrial vascularization. Subsequent caesarean section showed external adhesions on the anterior uterine serosa. A healthy baby of normal weight was delivered. There was focal placenta accreta; the underlying myometrium was strikingly thinner and prone to inversion. Discussion After B-Lynch sutures and ligation of the ascending branches of the uterine arteries, the pregnancy was subsequently uncomplicated. The potential association between B-Lynch sutures and placenta accreta or uterine inversion in a subsequent pregnancy has to be assessed in further studies. This case report illustrates how 3D gel instillation sonography is a valuable tool to evaluate the integrity of the uterine cavity., Highlights • 3D gel instillation sonography gives the best evaluation of the uterus after B-Lynch sutures have been used. • Normal fertility and pregnancy are possible after B-Lynch sutures have been used. • Normal fertility and pregnancy are possible after ligation of the uterine arteries. • B-Lynch sutures and ligation of the uterine arteries are useful in postpartum haemorrhage.
- Published
- 2021
16. Removable uterine compression sutures for postpartum haemorrhage.
- Author
-
Zhang, ZW, Liu, CY, Yu, N, and Guo, W
- Subjects
- *
SUTURES , *UTERINE hemorrhage treatment , *PUERPERAL disorders , *HYSTERECTOMY , *UTERINE rupture , *OPERATIVE surgery , *FERTILITY - Abstract
In 1997, B-Lynch and colleagues introduced the B-Lynch uterine compression suture for postpartum haemorrhage. Since then, various uterine compression sutures have been used and postpartum hysterectomy has been avoided in many women. However, some complications have emerged in years. In this article we discuss two types of uterine compression sutures in which stitches can be removed. The procedures have been successfully applied with no problems and no observed complications to date. This is a novel concept, with the potential to reduce morbidity related to compression sutures, but needs further evaluation. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
17. Uterine necrosis following a combination of uterine compression sutures and vascular ligation during a postpartum hemorrhage: A case report.
- Author
-
Benkirane, Saad, Saadi, Hanane, Serji, Badr, and Mimouni, Ahmed
- Abstract
Introduction The Postpartum bleeding is the first cause of maternal mortality in Morocco. It is an obstetrical emergency that requires a fast multimodal management including medical care, interventional procedure and in few cases a salvatory surgery. Clinical case We report a rare case of uterine necrosis following postpartum hemorrhage, refractory to medical therapy, and which was controlled by a combination of uterine hemostatic techniques and vascular ligation three days after surgery, the patient developed a fever (39 °C). At day 3 of postoperative period, the patient developed a fever (39 °C) associated with diffuse abdominal pain, diarrhea and non-fetid lochia. At day 5, she presented a state of sepsis. Abdominal and pelvic CT objectified gas bubbles in the uterine myometrium suggestive of necrosis. An exploratory laparotomy was performed. After adhesiolysis, exploration found a complete necrosis of the uterus Discussion There are many surgical techniques for the management of postpartum bleeding, and hysterectomy remains the reference solution in this context. However, new conservative surgical techniques that are easier to perform and are less aggressive have emerged and are becoming more commonly used. Conclusion We emphasize on the importance of choosing surgical techniques that lead to the preservation of uterine vascularization. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
18. Later reproductive health after B-Lynch sutures: a follow-up study after 10 years' clinical use of the B-Lynch suture.
- Author
-
Fuglsang, Jens
- Subjects
- *
REPRODUCTIVE health , *PREGNANCY complications , *HYSTERECTOMY complications , *FOLLOW-up studies (Medicine) , *WOMEN patients , *HEMORRHAGE - Abstract
Objective: To evaluate the reproductive prognosis after having a B-Lynch suture placed previously. Design: Follow-up study based on patients' records. Setting: University hospital setting (level three; 4,800 deliveries per year). Patient(s): All patients registered to have had a B-Lynch suture placed from 2002 to 2012. Intervention(s): None. Main Outcome Measure(s): Future pregnancies. Result(s): Forty-four B-Lynch procedures were identified in 43 women. Twenty-six were primiparas at the time of B-Lynch suture. Follow-up took place a median 45 months (range, 17–126 months) after B-Lynch suture placement; one woman was lost to follow-up. Overall, 16 of 42 women obtained a new pregnancy. Among primiparas, 44% either had an ongoing pregnancy or a delivery. Among women not having a succeeding pregnancy, one woman had a peripartum hysterectomy, one was advised against pregnancy, one developed Asherman's syndrome, and three women were known to attempt to obtain pregnancy. In deliveries after a previous B-Lynch suture, 3 of 13 women had estimated bleeding above 1,000 mL, and 2 of these had severe bleeding. A time trend was observed indicating that B-Lynch sutures are placed increasingly often. Conclusion(s): The reproductive prognosis after a B-Lynch suture has been placed seems to be relatively good. Nonetheless, complications that might influence future pregnancy may occur, and advice given should address this. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
19. Uterine flexion suture: modified B-Lynch uterine compression suture for the treatment of uterine atony during cesarean section
- Author
-
Metha Songthamwat and Srisuda Songthamwat
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Uterus ,International Journal of Women's Health ,B-Lynch ,uterine flexion suture ,03 medical and health sciences ,0302 clinical medicine ,Suture (anatomy) ,Maternity and Midwifery ,medicine ,Vaginal bleeding ,030212 general & internal medicine ,Original Research ,Hematometra ,030219 obstetrics & reproductive medicine ,Hysterectomy ,cesarean section ,business.industry ,Cephalopelvic disproportion ,Obstetrics and Gynecology ,Postoperative complication ,uterine atony ,medicine.disease ,uterine compression suture ,Surgery ,Uterine atony ,medicine.anatomical_structure ,Oncology ,Anesthesia ,medicine.symptom ,business - Abstract
Srisuda Songthamwat, Metha Songthamwat Department of Obstetrics and Gynecology, Udonthani Hospital, Udonthani, Thailand Objective: The aim of this study was to report our clinical experience of applying a uterine flexion suture, which was modified from the B-Lynch uterine compression suture, for treating uterine atony during cesarean section. Materials and methods: This is a retrospective descriptive study describing the use of a new technique, uterine flexion suture, for treating uterine atony during cesarean section. The study period was from January 2009 to December 2017 at Udonthani Hospital, Udonthani, Thailand. Uterine atony during cesarean section was treated by manual compression, intravenous oxytocin, methylergonovine maleate, and prostaglandins and then was observed for 10–15minutes before applying a uterine flexion suture in the failed medical treatment cases. The patients were observed for vaginal bleeding, hematometra, and infection after operation. Uterine ultrasound scan results on days 1, 7, and 30 postoperation were also reviewed. Results: Fifty-seven patients with uterine atony during cesarean delivery received the uterine flexion suture. The mean age of patients was 27.0 (15–44years). Thirty-four patients were primipara. The indications for cesarean section were cephalopelvic disproportion in 27 (47.4%) cases, and previous cesarean section in 11 (19.3%) cases. Neither postoperative excessive bleeding nor hysterectomy was observed. There was no hematometra or serious postoperative complication after surgery. The estimated time for uterine flexion suture is only 2–3minutes and was very easy to perform. Conclusion: Uterine flexion suture technique, which was modified from the B-Lynch suture, was inexpensive, quick, and effective in the treatment of atonic postpartum uterus in women undergoing cesarean section. Keywords: B-Lynch, uterine atony, cesarean section, uterine compression suture, uterine flexion suture
- Published
- 2018
20. Uterine compression sutures for postpartum hemorrhage: an overview.
- Author
-
Matsubara, Shigeki, Yano, Hitoshi, Ohkuchi, Akihide, Kuwata, Tomoyuki, Usui, Rie, and Suzuki, Mitsuaki
- Subjects
- *
HEMORRHAGE , *HEMOSTASIS , *UTERINE surgery , *SUTURING , *SURGICAL complications , *COMPRESSION therapy - Abstract
In 1997, B-Lynch pioneered the use of uterine compression sutures for postpartum hemorrhage. Since then, some researchers, including ourselves, have devised various uterine compression sutures. High-level evidence has not been demonstrated as to whether compression sutures achieve better and safer hemostasis for postpartum hemorrhage than other methods, and, if they do, whether one suture is more efficient and safer than another. However, generally speaking, uterine compression sutures have achieved hemostasis while preserving fertility in many women and thus their efficacy and safety have been time-tested. Each suture has both merits and drawbacks: obstetricians must be aware of the fundamental characteristics of various sutures. In this review, we summarize the technical procedures, efficacy, safety and complications of various uterine compression sutures. We add our own experiences and opinions where necessary. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
21. A novel technique for modified B- Lynch suture for the control of atonic postpartum haemorrhage.
- Author
-
Ali, Mohammed K., Badee, Ahmed Y. A., Abbas, Ahmed M., and Shazly, Sherif A.‐E. M.
- Subjects
- *
SUTURING , *HEMORRHAGE complications , *HEMORRHAGE , *LIGATURE (Surgery) , *LONGITUDINAL method , *HEALTH outcome assessment , *PUERPERAL disorders , *TREATMENT effectiveness , *DESCRIPTIVE statistics ,PREVENTION of surgical complications - Abstract
The B-Lynch brace suture technique is a life-saving procedure. It is a simple and safe alternative to hysterectomy. Thus, it preserves fertility with less surgical morbidity. In this case series, we evaluated the use of a novel modification of the B-Lynch brace suture to minimise its potential reported complications. Five women with intractable primary atonic postpartum haemorrhage were reported. They were initially managed with bilateral uterine artery ligation. The procedure was resorted to women who did not respond to ligation. The procedure is efficient. Women were followed up for up to 24 months to report any complications. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
22. New dedicated blunt straight needles and sutures for uterine compression sutures: a retrospective study and literature review
- Author
-
Matsuzaki, Shinya, Endo, Masayuki, Tomimatsu, Takuji, Nakagawa, Satoshi, Matsuzaki, Satoko, Miyake, Tatsuya, Takiuchi, Tsuyoshi, Kakigano, Aiko, Mimura, Kazuya, Ueda, Yutaka, and Kimura, Tadashi
- Published
- 2019
- Full Text
- View/download PDF
23. Management of intractable postpartum haemorrhage in a tertiary center: A 5-year experience.
- Author
-
Cengiz, Hüseyin, Yaşar, Levent, Ekin, Murat, Kaya, Cihan, and Karakaş, Sema
- Subjects
- *
HYSTERECTOMY , *HEMORRHAGE , *PUERPERAL disorders , *CRITICAL care medicine , *HUMAN fertility - Abstract
Background: The purpose of this study is to describe treatment alternatives to prevent postpartum hysterectomy after failure of conventional therapies. Prevention of hysterectomy was the main outcome studied. Materials and Methods: This is a retrospective study of 19 patients diagnosed to have intractable postpartum hemorrhage and not managed with medical treatment who were subsequently treated with operative interventions in our unit between January 2004 and January 2009. The cases were identified by review of medical records. Results: In the period under review, a total of 17,341 deliveries were conducted, out of which 19 women were managed for intractable PPH. The incidence of severe PPH unresponsive to standard medical treatment was 0.1%. The mean maternal age was 33.5±3.4 years (range 27-39 years). The mean gestational age was 38.3±1.3 weeks (range 37-41 weeks). Organ preserving surgery methods were utilized in all the patients with a success rate 78.9%. The mean duration of surgery was 95 minutes (range 50-130 minutes) and the mean hospital stay was for 5 days. The mean transfused blood volume was 2.4 units as packed red cells. Among these 19 cases, 4 cases were resorted to hysterectomy. Conclusions: In the presence of uncontrolled hemorrhage, this simple procedure should be tried before other complex treatment alternatives are undertaken. Our case series suggests that the combination of uterine artery ligation with B-Lynch sutures might be the best surgical approach because it preserves future fertility better than other methods and avoids high operative risks and morbidity. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
24. Uterine compression sutures for preserving fertility in severe postpartum haemorrhage: An overview 13 years after the first description.
- Author
-
Fotopoulou, C. and Dudenhausen, J. W.
- Subjects
- *
FERTILITY , *SUTURES , *ADNEXA uteri , *UTERINE hemorrhage , *ISCHEMIA - Abstract
We performed a systematic review of the current literature on efficacy, complications and impact on future pregnancies of uterine compression sutures (UCS) applied in cases of severe postpartum haemorrhage (PPH) in women who wish to preserve fertility. Publications related to UCS from their initial description 03/1996–07/2009, were identified using PubMed and EMBASE. Numerous case series have demonstrated the high efficiency of UCS against PPH. When performed correctly, they are associated with a low complications rate. A higher risk of uterine ischaemia seems to be caused when combined with vessel ligation. No negative impact on fertility has been reported. Uncomplicated future pregnancies occur within a range of 1–3 years. UCS appear safe, simple to learn and preserve future reproductive potential. They should be considered prior to definite measures like hysterectomy in severe PPH. Long-term follow-up is recommended when additional combined vessel ligation is performed due to the potential risk of ischaemic necrosis. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
25. Couvelaire Uterus ve Uterin Atoni Olgusunda B-Lynch Kompresyon Sütürü Başarısızlığı.
- Author
-
Aydın, Derya Sivri, Hasanova, Mushviqe, Göksedef, Pınar Çilesiz, Ekmez, Murat, and Çetin, Ahmet
- Abstract
In this paper, we aimed to discuss the reliability of B-Lynch suture, especially in patients with Couveliare uterus, and to present a patient who underwent bilateral uterine artery ligation in addition to B-Lynch compression suture for uterine atony resulting from abruptio placentae and developed retroperitoneal hematoma due to uterine laceration in the postpartum period. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
26. Uterine brace compression sutures for the treatment of post-partum haemorrhage.
- Author
-
Panayotidis, Costas and Abdo, Khalil
- Abstract
Haemostatic brace suturing techniques have been used recently for the treatment of massive post-partum haemorrhage due to uterine atony. Placement of these sutures can be considered before embarking on more technically complicated measures such as internal iliac artery ligation or hysterectomy. This article describes different uterine brace compression sutures, their advantages and complications and their place among other treatment modalities. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
27. The B-Lynch and other uterine compression suture techniques
- Author
-
Allam, M.S. and B-Lynch, C.
- Subjects
- *
OPERATIVE surgery , *ARTERIAL injuries , *UTERINE surgery , *HYSTERECTOMY - Abstract
Background: Postpartum hemorrhage (PPH) remains among the 5 main causes of maternal death in developing and developed countries, and uterine atony is the most common cause (75-90%) of primary PPH. Uterine compression sutures running through the full thickness of both uterine walls (posterior as well as anterior) have recently been described for surgical management of atonic PPH. Christopher B-Lynch was the first to highlight this revolutionary principle, and other uterine compression suture techniques have since been described by Hayman and Cho.Objectives: Step-by-step description of the B-Lynch brace suture and discussion of the current compression suture techniques.Conclusions: The different uterine suture techniques have proved to be valuable and safe alternatives to hysterectomy in the control of massive PPH, and the present review can make the surgeon better aware of their effective use and the risks they may entail. [ABSTRACT FROM AUTHOR]- Published
- 2005
- Full Text
- View/download PDF
28. The B-Lynch technique for postpartum haemorrhage: an option for every gynaecologist
- Author
-
Holtsema, Hilda, Nijland, Roel, Huisman, Aad, Dony, Julien, and van den Berg, Paul P.
- Subjects
- *
UTERINE hemorrhage , *OPERATIVE surgery , *HEMOSTASIS , *ARTERIES - Abstract
Postpartum haemorrhage may be a life threatening complication. Seven cases are described in which the B-Lynch surgical technique (a brace like suture over the uterus) was successful in obtaining haemostasis. In four cases, the B-Lynch technique was the first line of treatment. In three cases, the B-Lynch was used after, or in combination with artery or other vessel ligation. [Copyright &y& Elsevier]
- Published
- 2004
- Full Text
- View/download PDF
29. New dedicated blunt straight needles and sutures for uterine compression sutures: a retrospective study and literature review
- Author
-
Kazuya Mimura, Masayuki Endo, Satoko Matsuzaki, Satoshi Nakagawa, Yutaka Ueda, Tsuyoshi Takiuchi, Shinya Matsuzaki, Tadashi Kimura, Aiko Kakigano, Takuji Tomimatsu, and Tatsuya Miyake
- Subjects
Adult ,medicine.medical_specialty ,lcsh:Surgery ,Uterine body ,B-Lynch ,03 medical and health sciences ,Polydioxanone ,chemistry.chemical_compound ,0302 clinical medicine ,Blunt ,Suture (anatomy) ,Hayman suture ,medicine ,Retrospective analysis ,Needle ,Humans ,Uterine compression suture ,Retrospective Studies ,Poliglecaprone 25 ,Sutures ,business.industry ,Postpartum Hemorrhage ,Suture Techniques ,Uterus ,Retrospective cohort study ,General Medicine ,lcsh:RD1-811 ,Surgery ,Search terms ,chemistry ,Needles ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,business ,Research Article - Abstract
Background We developed a dedicated blunt straight needle with No. 2 polydioxanone sutures (2-Monodiox®) for uterine compression sutures (UCSs) and aimed to assess the outcomes and complication rates of UCSs for postpartum hemorrhage by comparing with commercially available needle and suture types. Methods A retrospective analysis was performed between January 2010 and February 2018. During the study period, two types of commercially available sutures and 2-Monodiox® were used. PubMed, MEDLINE, and Scopus databases were searched for English articles published between January 1997 and May 2017 using search terms related to the suture and needle types for UCSs to discuss the dedicated needles and sutures for UCS. Results The analysis included 47 cases of UCSs for the uterine body with three suture types (No. 0 polydioxanone, 7 cases; No. 1 poliglecaprone 25, 21 cases; and No. 2 polydioxanone, 19 cases). B-Lynch suture using No. 0 sutures was associated with a significantly lower uterine preservation rate than those with Nos. 1 and 2 sutures (42.9% vs. 95.2 and 89.5%, respectively; p
- Published
- 2018
30. Uterine necrosis following a combination of uterine compression sutures and vascular ligation during a postpartum hemorrhage: A case report
- Author
-
Saad Benkirane, Hanane Saadi, Ahmed Mimouni, and Badr Serji
- Subjects
Uterine compression sutures ,medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Necrosis ,postpartum bleeding ,business.industry ,Case Report ,Vascular ligation ,medicine.disease ,B-Lynch ,Medical care ,Surgery ,Postpartum hemorrhage ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Anesthesia ,medicine ,030212 general & internal medicine ,medicine.symptom ,Ligation ,business ,Uterine necrosis - Abstract
Highlights • After failure of medical treatment and triple vascular ligation, a combination of technique can be used, and very little article in the literature discusses the modalities of this combination to avoid Uterine Necrosis. • We emphasize the importance of choosing surgical techniques that lead to the preservation of uterine vascularization. • The preference is to triple ligation distal type Tsirulnikov supplemented if necessary by a B-Lynch. • After the use of uterine compression sutures, the patient requires maximum caution and monitoring for complications, the most serious of which is uterine necrosis., Introduction The Postpartum bleeding is the first cause of maternal mortality in Morocco. It is an obstetrical emergency that requires a fast multimodal management including medical care, interventional procedure and in few cases a salvatory surgery. Clinical case We report a rare case of uterine necrosis following postpartum hemorrhage, refractory to medical therapy, and which was controlled by a combination of uterine hemostatic techniques and vascular ligation three days after surgery, the patient developed a fever (39 °C). At day 3 of postoperative period, the patient developed a fever (39 °C) associated with diffuse abdominal pain, diarrhea and non-fetid lochia. At day 5, she presented a state of sepsis. Abdominal and pelvic CT objectified gas bubbles in the uterine myometrium suggestive of necrosis. An exploratory laparotomy was performed. After adhesiolysis, exploration found a complete necrosis of the uterus Discussion There are many surgical techniques for the management of postpartum bleeding, and hysterectomy remains the reference solution in this context. However, new conservative surgical techniques that are easier to perform and are less aggressive have emerged and are becoming more commonly used. Conclusion We emphasize on the importance of choosing surgical techniques that lead to the preservation of uterine vascularization.
- Published
- 2017
31. Failure of B-Lynch Compression Suture in a Patient with Couvelaire Uterus and Uterine Atony
- Author
-
Derya Sivri Aydın, Pınar Çilesiz Göksedef, Mushviqe Hasanova, Ahmet Çetin, and Murat Ekmez
- Subjects
Gynecology ,congenital, hereditary, and neonatal diseases and abnormalities ,lcsh:R5-920 ,medicine.medical_specialty ,business.industry ,couvelaire uterus atony ,lcsh:R ,compression suture ,lcsh:Medicine ,General Medicine ,medicine.disease ,Compression (physics) ,B-Lynch ,Surgery ,Couvelaire uterus ,Uterine atony ,Suture (anatomy) ,medicine ,lcsh:Medicine (General) ,business - Abstract
In this paper, we aimed to discuss the reliability of B-Lynch suture, especially in patients with Couveliare uterus, and to present a patient who underwent bilateral uterine artery ligation in addition to B-Lynch compression suture for uterine atony resulting from abruptio placentae and developed retroperitoneal hematoma due to uterine laceration in the postpartum period.
- Published
- 2016
32. Later reproductive health after B-Lynch sutures: a follow-up study after 10 years' clinical use of the B-Lynch suture
- Author
-
Jens Fuglsang
- Subjects
Adult ,medicine.medical_specialty ,Denmark ,media_common.quotation_subject ,Fertility ,B-Lynch ,Young Adult ,Postoperative Complications ,compression sutures ,Suture (anatomy) ,Pregnancy ,Risk Factors ,medicine ,Humans ,Young adult ,Reproductive health ,media_common ,fertility ,Sutures ,business.industry ,Obstetrics ,Incidence ,Incidence (epidemiology) ,Postpartum Hemorrhage ,Female infertility ,Pregnancy Outcome ,Obstetrics and Gynecology ,Prognosis ,medicine.disease ,Causality ,Reproductive Health ,Treatment Outcome ,Reproductive Medicine ,Female ,business ,Infertility, Female ,B-Lynch suture ,Follow-Up Studies - Abstract
OBJECTIVE: To evaluate the reproductive prognosis after having a B-Lynch suture placed previously.DESIGN: Follow-up study based on patients' records.SETTING: University hospital setting (level three; 4,800 deliveries per year).PATIENT(S): All patients registered to have had a B-Lynch suture placed from 2002 to 2012.INTERVENTION(S): None.MAIN OUTCOME MEASURE(S): Future pregnancies.RESULT(S): Forty-four B-Lynch procedures were identified in 43 women. Twenty-six were primiparas at the time of B-Lynch suture. Follow-up took place a median 45 months (range, 17-126 months) after B-Lynch suture placement; one woman was lost to follow-up. Overall, 16 of 42 women obtained a new pregnancy. Among primiparas, 44% either had an ongoing pregnancy or a delivery. Among women not having a succeeding pregnancy, one woman had a peripartum hysterectomy, one was advised against pregnancy, one developed Asherman's syndrome, and three women were known to attempt to obtain pregnancy. In deliveries after a previous B-Lynch suture, 3 of 13 women had estimated bleeding above 1,000 mL, and 2 of these had severe bleeding. A time trend was observed indicating that B-Lynch sutures are placed increasingly often.CONCLUSION(S): The reproductive prognosis after a B-Lynch suture has been placed seems to be relatively good. Nonetheless, complications that might influence future pregnancy may occur, and advice given should address this.
- Published
- 2014
33. Obstetrical outcome after B-Lynch sutures and ligation of uterine arteries: A case report.
- Author
-
Vanwinkel S, Claes L, and Van den Bosch T
- Abstract
Objective: To illustrate the obstetrical outcome after B-Lynch sutures and ligation of the uterine arteries., Case: A 26-year-old nulliparous woman. A caesarean section performed for obstructed labour was complicated by uterine atony. A B-Lynch uterine compression suture technique was used combined with ligation of the ascending branches of the uterine arteries. Before the subsequent fertility treatment, gel instillation sonography and power Doppler imaging showed a normal uterine cavity and restored myometrial vascularization. Subsequent caesarean section showed external adhesions on the anterior uterine serosa. A healthy baby of normal weight was delivered. There was focal placenta accreta; the underlying myometrium was strikingly thinner and prone to inversion., Discussion: After B-Lynch sutures and ligation of the ascending branches of the uterine arteries, the pregnancy was subsequently uncomplicated. The potential association between B-Lynch sutures and placenta accreta or uterine inversion in a subsequent pregnancy has to be assessed in further studies. This case report illustrates how 3D gel instillation sonography is a valuable tool to evaluate the integrity of the uterine cavity., (© 2021 The Authors.)
- Published
- 2021
- Full Text
- View/download PDF
34. Management of intractable postpartum haemorrhage in a tertiary center: A 5-year experience
- Author
-
Hüseyin Cengiz, Sema Karakas, Murat Ekin, Cihan Kaya, and Levent Yaşar
- Subjects
medicine.medical_specialty ,Hysterectomy ,business.industry ,Incidence (epidemiology) ,medicine.medical_treatment ,Medical record ,Gestational age ,Retrospective cohort study ,General Medicine ,Postpartum Hysterectomy ,B-Lynch ,Surgery ,postpartum hemorrhage ,Intensive care ,medicine.artery ,uterine artery ligation ,Medicine ,Original Article ,hysterectomy ,business ,Uterine artery ,intensive care - Abstract
Background: The purpose of this study is to describe treatment alternatives to prevent postpartum hysterectomy after failure of conventional therapies. Prevention of hysterectomy was the main outcome studied. Materials and Methods: This is a retrospective study of 19 patients diagnosed to have intractable postpartum hemorrhage and not managed with medical treatment who were subsequently treated with operative interventions in our unit between January 2004 and January 2009. The cases were identified by review of medical records. Results: In the period under review, a total of 17,341 deliveries were conducted, out of which 19 women were managed for intractable PPH. The incidence of severe PPH unresponsive to standard medical treatment was 0.1%. The mean maternal age was 33.5±3.4 years (range 27–39 years). The mean gestational age was 38.3±1.3 weeks (range 37–41 weeks). Organ preserving surgery methods were utilized in all the patients with a success rate 78.9%. The mean duration of surgery was 95 minutes (range 50–130 minutes) and the mean hospital stay was for 5 days. The mean transfused blood volume was 2.4 units as packed red cells. Among these 19 cases, 4 cases were resorted to hysterectomy. Conclusions: In the presence of uncontrolled hemorrhage, this simple procedure should be tried before other complex treatment alternatives are undertaken. Our case series suggests that the combination of uterine artery ligation with B-Lynch sutures might be the best surgical approach because it preserves future fertility better than other methods and avoids high operative risks and morbidity.Keywords: B-Lynch, hysterectomy, intensive care, postpartum hemorrhage, uterine artery ligationNigerian Medical Journal | Vol. 53 | Issue 2 | April-June | 2012
- Published
- 2012
35. A new removable uterine compression by a brace suture in the management of severe postpartum hemorrhage
- Author
-
Shigeki Matsubara, Hironori Takahashi, and Alan Kawarai Lefor
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,lcsh:Surgery ,B-Lynch ,Abdominal wall ,Suture (anatomy) ,medicine ,Uterine compression suture ,Synechia ,Transfix ,Hysterectomy ,business.industry ,General Commentary ,Postpartum Hemorrhage ,removable suture ,Anatomy ,lcsh:RD1-811 ,medicine.disease ,Uterine atony ,Surgery ,medicine.anatomical_structure ,Uterine cavity ,Foreign body ,business - Abstract
Aboulfalah et al. (1) introduced a unique technique for a uterine compression suture (UCS), which included suture removal within 48 h after delivery. This technique is epoch-making. To obstetricians, the year 1997 is memorable regarding the treatment of postpartum hemorrhage (PPH), when B-Lynch et al. introduced the UCS (2), which dramatically changed the treatment of PPH from hysterectomy to uterus-conserving UCS. During the last two decades, up to 15 modified UCS techniques have been published; we introduced the Matsubara–Yano (MY) UCS (2). The hemostatic effectiveness of the UCS is well established (2). Uterine compression suture is not without side effects, including uterine necrosis, synechia, and infection (2). The UCS, by apposing the anterior and posterior uterine walls with a tied suture, necessarily limits blood flow to the uterus, which may cause uterine ischemia. The UCS remains in the uterine cavity until it is absorbed, which may lead to uterine infection. In either scenario, the suture is the culprit. Since the incidence rate of these adverse events is considered low, leaving the suture in place is considered a “necessary evil” for this life-saving procedure (2). The uterus usually contracts within a short period of time after delivery, resulting in hemostasis, and, thus, the “critical period” requiring the hemostatic effect of the UCS may be only 24–48 h after delivery. After this period, uterine compression may no longer be needed. Since the suture is responsible for adverse events and since uterine compression may be no longer needed after 48 h, removing the suture after 48 h may reduce the incidence of complications. Aboulfalah et al. (1) reported this approach, and that is why we consider their technique as epoch-making. Here, we offer clarification and concern. Clarification is needed regarding the technical procedure. The explanation offered by Aboulfalah may be a little obscure. Since they stated, “this technique deserves to be applied in greater number,” its clarification may be valuable for those unfamiliar with the technique. We interpret their technique as follows. A needle is used to penetrate the abdominal wall just above the symphysis pubis and then transfix the uterus (anterior → posterior) in the lower uterine segment (Point A in Figures Figures1A,B).1A,B). Then, the suture runs over the uterine fundus. This is Hayman’s simple brace suture (2). Then, importantly, the needle penetrates the abdominal wall (abdominal cavity → surface) at a site 2 cm cephalad to the initial puncture site (Point B in Figures Figures1A,B).1A,B). The same procedure is then performed on the opposite side. The suture is tied outside the abdominal wall: lower with lower, and upper with upper sutures (Figure (Figure1B,1B, upper inset). By tying the sutures tightly, the uterus assumes a marked ante-flexion position and is compressed against the pubis (Figure (Figure11B). Figure 1 Schematic presentation of the Aboulfalah removable uterine compression suture (A,B), our proposed concept (C), and sliding out/in of the suture (D). (A) The Aboulfalah technique. The upper inset illustrates the anterior view. (B) Tying the suture in the ... We have two technical concerns: possible weaker compression and the risk of the suture sliding. Publication delay prevented Aboulfalah et al. from citing our recent article (3) in which a similar technique was proposed, although theoretical, employing the concept of a removable UCS. Figure Figure1C1C illustrates the proposed concept. The Hayman suture (upper inset left) is performed. The MY suture is also applicable, in which not only the lower uterine segment but also upper part of the uterine body is transfixed (Figure (Figure1C1C upper inset right). In either technique, the suture is tied outside the abdominal wall. Regardless whether the Hayman or MY suture is employed, in a manner different from the Aboulfalah technique, the cephalad suture is placed more cephalad than in the Aboulfalah technique (comparing point B in Figure Figure1A1A vs. Figure Figure1C).1C). In the Aboulfalah technique, the cephalad suture is placed more caudally on the abdominal wall. Thus, the anterior part of the uterus may not be well compressed (star in Figure Figure1B).1B). This allows a space to form between the abdominal wall and the uterine anterior surface (comparing the stars in Figures Figures1B,C).1B,C). Furthermore, compared with our technique, the suture runs freely over a longer distance (Figure (Figure1B),1B), and thus, the suture “sliding out” (Figure (Figure1D1D upper) or “sliding in” (Figure (Figure1D1D lower) may occur more frequently. As we have pointed out (2), sliding out/in sometimes occurs with the Hayman or B-Lynch sutures and preventing effective uterine compression. Thus, our technique may have (1) more compression and (2) less chance of the suture sliding out/in, but may have no hemostatic mechanism derived by “compression of the uterus against the pubis.” The inverse is true of the Aboulfalah technique. In our opinion, if the compression force is strong, uterine compression against the pubis may not necessarily be needed. This approach favors sufficient compression by the suture alone, compared with against the pubis compression. Although theoretical, we proposed another technique for removing the suture, employing vaginal removal of the suture (3, 4). Quite recently, this concept was described by other investigators (5). Further study is needed to determine which route, abdominal or vaginal, may be better for removing the UCS. In either scenario, the procedure should be safe and easy. We believe that “removing a foreign body” is a fundamental concept in the practice of medicine (3). The year 1997 opened a new era of PPH treatment. However, the concept of a UCS is not yet complete. The presence of various modifications of the UCS indicates that there is no “best” method for placing or removing a UCS. A removable UCS may be promising and its introduction may open a second new era of PPH treatment. Wider discussion may hasten adoption of this technique.
- Published
- 2015
36. Microencapsulated Garcinia kola and Hunteria umbellata Seeds Aqueous Extracts Part 1: Effect of microencapsulation process
- Author
-
Arhewoh, Matthew, Augustine, Okhamafe O., Finizia, Auriemma, Claudio, De Rosa, Rocco, Di Girolamo, Arhewoh, Matthew, Augustine, Okhamafe O., Finizia, Auriemma, Claudio, De Rosa, and Rocco, Di Girolamo
- Abstract
Objective: This study investigates microcapsulated aqueous extracts of Garcinia kola (GK) and Hunteria umbellata (HU) seeds. Method: Extracts obtained after maceration of dried powdered seeds were prepared as microcapsules with chitosan-alginate by counterion coacervation method. Microcapsules were characterized using differential scanning calorimetry (DSC), x-ray diffractometry (XRD) and fourier transform infrared (FTIR) spectroscopy. In vitro release studies were carried out at pH 1.2 for 2 h and 6.8 for a further 10 h. Results : Between 20 and 50% extract release occurred from microcapsules after 2 h while conventional tablets released 100% after 1 h at simulated gastric pH. At pH 6.8, >80% of extract was released from microcapsules after 6 h. DSC revealed the presence of complex materials. XRD and FTIR showed stable character of the plant extracts within the microcapsules. Conclusion: Controlled release of aqueous extracts derived from these plants was achieved by microencapsulation and therefore can be developed as suitable delivery devices.
- Published
- 2015
37. Die B-Lynch-Naht: Technik und Vergleich mit der bimanuellen Uteruskompression
- Author
-
Lachmann, R., Kamin, G., Kamil, D., Van De Vondel, P., Staboulidou, I., and Distler, W.
- Published
- 2008
- Full Text
- View/download PDF
38. B-Lynch suture in the treatment of peripartal hemorrhage due to uterine atony during caesarean section - a 5 year experience
- Author
-
Habek, Dubravko, Prka, Matija, Predojević, Maja, and Marton, Ingrid
- Subjects
congenital, hereditary, and neonatal diseases and abnormalities ,nutritional and metabolic diseases ,reproductive and urinary physiology ,digestive system diseases ,B-Lynch ,atonija maternice - Abstract
B-Lynch suture in the treatment of peripartal hemorrhage due to uterine atony during caesarean section - a 5 year experience.
- Published
- 2013
39. Sutura de B Lynch, para el control de la hemorragia posparto: presentación de tres casos
- Author
-
Angulo, Alicyoy, Colina, María Francia, Galiano, José, and Madail, Angélica
- Subjects
B-lynch ,Postpartum hemorrhage ,Atonía uterina ,Hemorragia posparto ,Uterine atony - Abstract
Objetivo: Informar el resultado de 3 casos de hemorragia posparto, tratados con la técnica de suturas de B-Lynch, previo masaje uterino y administración de medicamentos. Ambiente: Las pacientes fueron atendidas en el Servicio de Obstetricia y Ginecología del Hospital Miguel Pérez Carreño, en el período comprendido entre enero de 2011 a junio de 2011. Método: Se presentan 3 casos en los que se realizó la técnica de sutura de B-Lynch, para el control de la hemorragia posparto. Resultados: En los 3 casos se logró exitosamente controlar la hemorragia posparto y preservar el útero. Conclusión: Nuestros resultados permiten afirmar que la técnica de B-Lynch es segura, útil y reproducible en el manejo de la hemorragia posparto. Objective: To report the results of 3 cases of postpartum hemorrhage treated with the technique of B-Lynch suture, uterine massage prior administration of medications. Setting: Patients were treated at the Department of Obstetrics and Gynecology, Hospital Miguel Perez Carreno, in the period from January 2011 to June 2011. Method: 3 show cases where the technique was performed for B-Lynch suture, to control postpartum hemorrhage. Results: In all 3 cases was successfully manage postpartum hemorrhage and preserve the uterus. Conclusion: Our results suggest that the B-Lynch technique is safe, useful and reproducible in the management of postpartum hemorrhage.
- Published
- 2012
40. Uterine compression suture may be useful not only for hemostasis in postpartum hemorrhage but also for prophylaxis of acute recurrence of uterine inversion.
- Author
-
Matsubara, Shigeki
- Subjects
- *
ADNEXA uteri , *HEMOSTASIS , *HEMORRHAGE , *ABDOMINAL surgery , *UTERUS - Abstract
Uterine compression suture is a safe and effective technique for hemostasis in postpartum hemorrhage. This technique was useful for the prophylaxis of acute recurrence of uterine inversion, which was repositioned under laparotomy. We add a new compression suture to the list of those introduced by earlier researchers. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
41. A Commentary on: "A New Removable Uterine Compression by a Brace Suture in the Management of Severe Postpartum Hemorrhage".
- Author
-
Matsubara S, Takahashi H, and Lefor AK
- Published
- 2015
- Full Text
- View/download PDF
42. The combination of intrauterine balloon tamponade and the B-Lynch procedure for the treatment of severe postpartum hemorrhage.
- Author
-
Diemert, Anke, Ortmeyer, Gerhard, Hollwitz, Bettina, Lotz, Manuela, Somville, Thierry, Glosemeyer, Peter, Diehl, Werner, and Hecher, Kurt
- Subjects
INTRAUTERINE blood transfusion ,HEMORRHAGE treatment ,HYSTERECTOMY ,DELIVERY (Obstetrics) ,CHILDBIRTH ,THERAPEUTICS ,SUTURES ,RETROSPECTIVE studies - Abstract
Objective: To evaluate intrauterine balloon tamponade with or without B-Lynch sutures in avoiding postpartum hysterectomy in cases with severe postpartum hemorrhage. Study Design: Retrospective analysis using all women delivering between January 2005 and July 2010 in our center. Prevention of hysterectomy was the main outcome studied. Results: Twenty-four cases of severe postpartum hemorrhage occurred in which medical treatment alone failed. In 20 cases, the Bakri balloon was the first choice to stop hemorrhage. Sixty percent (n = 12) of these were successfully treated with the balloon alone, 30% (n = 6) with the balloon and the B-Lynch suture. Therefore, 90% (n = 18) were successfully treated with the balloon as part of the treatment. The balloon tamponade was not successful in 2 cases. Four cases were treated with emergency hysterectomy a priori. Conclusion: The Bakri balloon with or without B-Lynch sutures in a stepwise approach is an effective option for the treatment of severe PPH. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
43. Complications and pregnancy outcome following uterine compression suture for postpartum haemorrhage: a single centre experience.
- Author
-
Liu S, Mathur M, and Tagore S
- Subjects
- Adult, Endometritis etiology, Female, Fertility Preservation, Humans, Pregnancy, Pregnancy Outcome, Pressure, Pyometra etiology, Retrospective Studies, Uterine Inertia surgery, Vaginal Discharge etiology, Young Adult, Hemostatic Techniques adverse effects, Postpartum Hemorrhage surgery, Suture Techniques adverse effects, Uterus surgery
- Abstract
In the treatment of postpartum haemorrhage from uterine atony, uterine compression sutures, such as the B-Lynch suture and its modifications have a role with the advantage of preservation of the uterus for fertility. There is however, a risk that apposition of the anterior and posterior walls of the uterus will impede drainage of lochia, resulting in undesirable complications. We undertook a five-year retrospective study of all women who underwent uterine compression sutures at the KK Women's and Children's Hospital, between 2008 and 2012. In total, 23 women had uterine compression sutures during the study period, of which, nineteen women managed to conserve their uterus. Our complication rate was 25%, which included persistent vaginal discharge, pyometra and endometritis. There were three conceptions, with two successful pregnancies. Our study shows uterine compression suture to be a safe and effective alternative to avoid hysterectomy with preservation of fertility at the time of major postpartum haemorrhage. The outcome of subsequent pregnancies is reassuring.
- Published
- 2014
- Full Text
- View/download PDF
44. Uterine salvage management for atonic postpartum hemorrhage using 'modified lynch suture'
- Author
-
M. El-Sokkary, K. Wahba, and Y. El-Shahawy
- Subjects
Adult ,medicine.medical_specialty ,Randomization ,medicine.medical_treatment ,Uterus ,Hysterectomy ,B-Lynch ,03 medical and health sciences ,0302 clinical medicine ,Suture (anatomy) ,Blood loss ,Pregnancy ,Atony ,medicine.artery ,Obstetrics and Gynaecology ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Uterine artery ,Ligation ,Salvage Therapy ,030219 obstetrics & reproductive medicine ,Sutures ,business.industry ,Cesarean Section ,Postpartum Hemorrhage ,Suture Techniques ,Obstetrics and Gynecology ,Atonic postpartum hemorrhage ,Uterine salvages ,Surgery ,Uterine Artery ,medicine.anatomical_structure ,Treatment Outcome ,Female ,medicine.symptom ,business ,Uterine Inertia ,Research Article - Abstract
Background To assess the effectiveness of the new modified technique in order to control bleeding in women presenting with atonic, flabby uterus compared to the most commonly described technique of classic B-Lynch suture. Method This study included 160 women of uncontrolled atonic postpartum hemorrhage delivered by cesarean section at Ain Shams University Maternity Hospital between January 2013 and October 2015. Participants were randomly assigned following simple randomization procedures (computerized random numbers) and divided into two groups. Group, I (80 patients) operated upon by the modified (new technique) stitch while group II (80 patients) operated upon by the classic technique. The ultimate goals were to stop blood loss after placement of the sutures and avoid life-saving hysterectomy thus preserving the life and fertility of the patient. Results The modified new technique was done in 80 patients with atonic postpartum hemorrhage and it was found to be superior to the classic technique with a success rate 95 % (4 cases needed hysterectomy as a lifesaving measure) compared to 85 % with the classic technique (in 12 cases, a life-saving hysterectomy was done). Conclusions This technique can replace the classic B-lynch in flabby unresponsive atonic uteri as it has 8 shaped placement of the stitch which causes more firm compression on the uterus and simultaneous bilateral uterine artery ligation. This technique was proved valuable and successful in many patients who suffer from uncontrolled massive postpartum hemorrhage (PPH).
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.