title: B-Lynch uterine compression sutures in the conservative surgical management of uterine atony.
abstract: OBJECTIVE
  To evaluate the success rate and possible complications of the B-Lynch uterine compression sutures in women who suffered from postpartum uterine atony unresponsive to medical treatment.
  
  
  METHODS
  A total of 36 women who were managed with the B-Lynch suture, with or without additional surgical procedures following uterine atony unresponsive to medical treatment, were evaluated retrospectively.
  
  
  RESULTS
  Sixteen women were primarily managed with the B-Lynch compression sutures, and 11 women had the B-Lynch compression sutures following failure of achievement of hemostasis by ligation of uterine artery alone (n = 4), or uterine artery plus uterine branch of ovarian artery (n = 7). Eight women had bilateral internal iliac artery ligation (BIIAL) following failure of achievement of hemostasis by the B-Lynch compression sutures. Two women (5.5%) underwent post-cesarean hysterectomy. The overall success rate of B-Lynch was 75% (27/36), and the overall success rate of B-Lynch plus BIIAL was 94.4% (34/36). Three women were admitted to the intensive care unit. There was no death related to the hemorrhage in our series. No short-term complications such as uterine necrosis, hematometra, pyometra, or uterine erosion related to the uterine compression suture were observed.
  
  
  CONCLUSIONS
  Overall success rate of the B-Lynch sutures and B-Lynch sutures plus BIIAL was 75 and 94.4%, respectively. The B-Lynch technique does not necessarily require specific suture material. Uterine devascularization or BIIAL did not increase the risk of the possible short-term complications such as uterine necrosis. In case of failure of the B-Lynch uterine compression sutures, BIIAL may be beneficial to save the uterus.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Near East University, Lefkosa-TRNC, Mersin 10, Turkey, drbariskayaizmir@gmail.com.
authors.forename: Baris
authors.initials: B
authors.lastname: Kaya
authors.forename: Abdullah
authors.initials: A
authors.lastname: Tuten
authors.forename: Korkut
authors.initials: K
authors.lastname: Daglar
authors.forename: Murat
authors.initials: M
authors.lastname: Onkun
authors.forename: Seyhun
authors.initials: S
authors.lastname: Sucu
authors.forename: Askin
authors.initials: A
authors.lastname: Dogan
authors.forename: Orhan
authors.initials: O
authors.lastname: Unal
authors.forename: Onur
authors.initials: O
authors.lastname: Guralp
mesh_terms: D000328:Adult; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008026:Ligation; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome; D014593:Uterine Inertia / Q000503:physiopathology / Q000601:surgery*; D014599:Uterus / Q000601:surgery*