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Obstetrics & Gynecology 2002;99:502-506
© 2002 by The American College of Obstetricians and Gynecologists
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CASE REPORTS

Uterine Compression Sutures: Surgical Management of Postpartum Hemorrhage

R. G. Hayman, S. Arulkumaran and P. J. Steer

Department of Obstetrics and Gynaecology, Derby City Hospital, Derby, United Kingdom; and Department of Maternal Fetal Medicine, Imperial College School of Medicine, Chelsea and Westminster Hospital, London, United Kingdom

Address reprint requests to: R. G. Hayman, Department of Obstetrics and Gynaecology, Derby City Hospital, Uttoxeter Road, Derby DE22 3NE, United Kingdom; E-mail: richard.hayman{at}nottingham.ac.uk.

ABSTRACT

BACKGROUND: It 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.

CASES: This 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.

CONCLUSION: Compression 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.




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