B-Lynch Suture Management among Patients with Postpartum Hemorrhage in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Postpartum haemorrhage is the most life-threatening complication during pregnancy and atonic postpartum haemorrhage being the commonest one, often poses difficulties in management. B-Lynch suture with a high success rate has emerged as a life-saving measure in uncontrolled atonic postpartum haemorrhage refractory to uterotonics. The objective of this study was to find out the prevalence of B-Lynch suture management among patients with post-partum haemorrhage in a tertiary care centre.

Methods: This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology of a tertiary care centre from 1 April 2017 to 1 April 2021 after taking ethical approval from the Institutional Review Committee of the same institution [Reference number: 497(6-11)C-2077/078]. All patients with post-partum haemorrhage during the study period were included in the study. Patients with traumatic post-partum haemorrhage, congenital malformations, complete placenta previa/accreta, bleeding disorders, disseminated intravascular coagulation, and retained bits of placenta were excluded from the study. A convenience sampling method was used. Point estimate and 90% Confidence Interval were calculated.

Results: Out of 72 patients, 19 (26.39%) (17.85-34.93, 90% Confidence Interval) underwent B-Lynch suture management for atonic post-partum haemorrhage. Uterus salvage was done in 18 (94.74%) whereas 1 (5.26%) underwent a cesarean hysterectomy.

Conclusions: The prevalence of the use of B-Lynch suture was similar to other studies done in similar settings. B-Lynch suture is a valuable addition for controlling intractable atonic primary postpartum haemorrhage refractory to uterotonics, thus saving the life as well as preserving the future fertility of the woman.

Keywords: cesarean section; postpartum haemorrhage; suture.