title: PP022 The haemostatic suture (technique of B-Lynch) may be an alternative to control uterine hemorrhage associated with hypertensive disorders.
abstract: BACKGROUND
  Postpartum haemorrhage is an important cause of maternal morbidity and mortality, uterine atony being responsible for most of the cases. Hypertensive disorders are supposed to increase the possibility of such complications, mainly when complicated by "abruptio placentae". The classical treatments for postpartum haemorrhage have been based on medications like oxytocin and misoprostol, but more recently a haemostatic uterine suture developed by Christopher B-Lynch has been indicated. Here, we describe our experience of performing such technique and investigate its results in patients complicated by hypertensive disorders.
  
  
  OBJECTIVE
  Reporting a series of cases of postpartum haemorrhage treated with the B-Lynch suture.
  
  
  METHODS
  This is a descriptive study including 39 patients treated with the B-Lynch suture after postpartum haemorrhage related to uterine atony. The period evaluated was between January 2005 and February 2012. Intravascular oxytocin was routinely used in all cases, with doses changing from 20 to 60 IU. The suture material used was chromed catgut 1.0mm.
  
  
  RESULTS
  The mode of delivery was cesarean-section in all cases. Five patients (12.8%) had hypertensive disorder as additional complication and one of these patients had abruptio placentae followed by development of Couvelaire uterus. Overall, the B-Lynch technique helped to control haemorrhage in all cases evaluated.
  
  
  CONCLUSIONS
  We believe that the B-Lynch technique appears as an important procedure to be indicated in cases of postpartum haemorrhage. Therefore, we recommend that this technique should be tried to control such complications before deciding for other more aggressive procedures like hysterectomy. It seems that this treatment may be used in patients complicated by hypertensive disorders.
authors.affiliation: Obstetrícia, Maternidade Vila Nova Cachoeirinha, Sao Paulo, Brazil.
authors.forename: H
authors.initials: H
authors.lastname: Korkes
authors.affiliation: Obstetrícia, Maternidade Vila Nova Cachoeirinha, Sao Paulo, Brazil.
authors.forename: L G
authors.initials: LG
authors.lastname: Oliveira
authors.affiliation: Obstetrícia, Maternidade Vila Nova Cachoeirinha, Sao Paulo, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: Watanabe
authors.affiliation: Obstetrícia, Maternidade Vila Nova Cachoeirinha, Sao Paulo, Brazil.
authors.forename: T T
authors.initials: TT
authors.lastname: Aoki
authors.affiliation: Obstetrícia, Maternidade Vila Nova Cachoeirinha, Sao Paulo, Brazil.
authors.forename: C L
authors.initials: CL
authors.lastname: Ramos
authors.affiliation: Obstetrícia, Maternidade Vila Nova Cachoeirinha, Sao Paulo, Brazil.
authors.forename: G
authors.initials: G
authors.lastname: Nagahama
authors.affiliation: Obstetrícia, Maternidade Vila Nova Cachoeirinha, Sao Paulo, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Marques
authors.affiliation: Obstetrícia, Maternidade Vila Nova Cachoeirinha, Sao Paulo, Brazil.
authors.forename: C
authors.initials: C
authors.lastname: Negrao
authors.affiliation: Obstetrícia, Maternidade Vila Nova Cachoeirinha, Sao Paulo, Brazil.
authors.forename: V
authors.initials: V
authors.lastname: Denise
authors.affiliation: Obstetrícia, Maternidade Vila Nova Cachoeirinha, Sao Paulo, Brazil.
authors.forename: N
authors.initials: N
authors.lastname: Sass