title: Modiﬁed anchored B-Lynch uterine compression suture for post partum bleeding with uterine atony.
abstract: A prospective observational study was performed to evaluate the performance of a modified uterine compression suturing technique for the management of refractory post partum hemorrhage (PPH) at two leading tertiary referral centers in Colombo, Sri Lanka. An modified anchored B-Lynch suture was done in 17 women with PPH due to uterine atony. In 13 of the women (76%), bleeding was arrested and the uterus conserved. Four women (24%) did not respond to the anchored compression sutures, necessitating emergency post partum hysterectomy. Mean age was 31.2 years. Nine of the women (53%) were primiparous and eight (47%) parous. Mean estimated blood loss was 1994 ml (range 1200-3300 ml). This newly modified anchor B-Lynch compression suture appeared effective in controlling about 75% of PPH due to uterine atony, which allowed uterine conservation. This simple modification can provide a first line surgical step to control PPH.
authors.affiliation: Obstetrics and Gynecology, Colombo South Teaching Hospital, Kalubowila, Sri Lanka. jeevanmarasinghe@yahoo.com
authors.forename: Jeevan P
authors.initials: JP
authors.lastname: Marasinghe
authors.forename: George
authors.initials: G
authors.lastname: Condous
authors.forename: Harshalal R
authors.initials: HR
authors.lastname: Seneviratne
authors.forename: Upali
authors.initials: U
authors.lastname: Marasinghe
mesh_terms: D000328:Adult; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D008026:Ligation; D011182:Postoperative Care / Q000379:methods; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery*; D011247:Pregnancy; D011446:Prospective Studies; D013188:Sri Lanka; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome; D014593:Uterine Inertia / Q000601:surgery*; D014599:Uterus / Q000601:surgery*; D016387:Women's Health; D055815:Young Adult