Evaluation of multiple square sutures versus b-lynch as an alternative to hysterectomy in severe postpartum hemorrhage during cesarean section

Abstract EN

Objective : to evaluate the success and outcomes of multiple square sutures and B-lynch as an alternative to hysterectomy in severe postpartum hemorrhage (PPH) during cesarean section.

Patients and Methods: this study had been carried out in Yemen at Elslam hospital during the period from March 2011 to march 2014.

The study was performed on thirty seven patients with severe postpartum hemorrhage during cesarean section were subjected to either hemostatic multiple square sutures (19 cases) or B-lynch sutures after failure of medical treatment and before proceeding to other surgical procedures as hysterectomy.

Results : multiple square sutures are more effective than B-lynch suture for controlling massive postpartum hemorrhage as alternative to cesarean hysterectomy at cesarean section (with success rate 91.3% versus 72.2%) with return of normal menstruation in the majority of cases but result in insignificant higher rate of intrauterine adhesions.

Conclusion and Recommendation : multiple square sutures are easy, simple and rapid method and more effective than B-lynch suture in controlling severe postpartum hemorrhage as an alternative to hysterectomy but further studies is needed to evaluate long term fertility rate and pregnancy outcomes.