Uterine compression sutures, an update: review of efficacy, safety and complications of B-Lynch suture and other uterine compression techniques for postpartum haemorrhage.
Since the advent of uterine compression suture by B-Lynch, numerous techniques have been advocated. We aim to discuss these various techniques with respect to their efficacy, safety, complications, complexity of the technique itself, future fertility and menstrual periods. Since no randomized controlled trials are available, the conclusions are based on weak data derived from observational studies and case series. A success rate of 91.7% has been reported for various uterine compression sutures. There are concerns regarding closure of uterine cavity and blood entrapment resulting in infection, pyometra and adhesions as the uterus will be transfixed from front to back in some of the suturing techniques. Long-term follow-up regarding fertility of patients who had uterine compression sutures is urgently needed. Data on menstrual periods after uterine compression sutures is limited. Our review is limited in nature due to lack of consistent data on many important outcomes and also preclinical variables.
Mallappa Saroja
Channamallikarjuna Swamy
CS
Department of Obstetrics and Gynaecology, Nevill Hall Hospital, Gwent Healthcare NHS Trust, Brecon Road, Abergavenny, Gwent, Wales, UK. drmscswamy@yahoo.com
Nankani
Angana
A
El-Hamamy
Essam
E
D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000601:surgery*; D011247:Pregnancy; D013536:Suture Techniques / Q000009:adverse effects