The B-Lynch technique for the management of intraoperative uterine atony

M Enriquez, Miguel Enríquez, G. Maruri, G. Ezeta, L Hidalgo, Faustino R. Pérez‐López, F R Pérez-López, P Chedraui, Peter Chedraui
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology · 2012 · vol. 32(4) , pp. 338–341 · doi:10.3109/01443615.2012.673035 · PMID:22519476 · W2132618343
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The B-Lynch suture effectively controlled intraoperative uterine atony during caesarean sections in 95.3% of cases, avoiding hysterectomy and maternal deaths without reported long-term complications.

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Abstract

This paper reports the experience of 150 B-Lynch suture applications for the management of uterine atony during caesarean section that did not respond to conventional therapeutical measures. Technique was considered effective if the need for hysterectomy was avoided. High-risk antenatal obstetrical conditions included: pre-eclampsia (12%), oligohydramnios (8%), polyhydramnios (4.7%). A total of 36% were primigravid, 66% had been in active labour, 4.7% received misoprostol and 26.7% used oxytocin for labour augmentation. Suture was successful in 95.3%, with only five cases requiring hysterectomy combined with uterine artery ligation and two uterine artery ligations alone to control bleeding and uterine atony ('floppiness'). Although 26.7% of cases required transfusions, no maternal deaths were reported, and overall women were discharged after a median 4-day hospital stay without further complications upon follow-up. The B-Lynch technique was an effective intraoperative measure to control uterine atony. Despite the encouraging results, long term assessment on a larger sample is needed in our clinical scenario.

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MeSH descriptors

Cesarean Section Intraoperative Complications Suture Techniques Uterine Inertia Cesarean Section Female Humans Intraoperative Complications Postoperative Complications Pregnancy Prospective Studies Treatment Outcome Uterine Inertia Uterus Uterus Uterus

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