The B-Lynch suturing technique (brace suture) may be particularly useful because of its simplicity of application, life saving potential, relative safety, and its capacity for preserving the uterus and thus fertility. Satisfactory haemostasis can be assessed immediately after application. If it fails, which has not yet been the case, other more radical surgical methods as mentioned in this paper and in the literature can be considered. The special advantage of this innovative technique is an alternative to major surgical procedures to control pelvic arterial pulse pressure or hysterectomy. This suturing technique has been successfully applied with no problems to date and no apparent complications.Postpartum haemorrhage is a serious obstetric problem. Life threatening postpartum haemorrhage can be a nightmare. Current clinical methods are unsuitable for the objective assessment of postpartum haemorrhage, and each patient's ability to compensate varies considerably. There are no reliable data on the true incidence of severe life threatening postpartum haemorrhage. The morbidity and mortality rise not only with delay in diagnosis and treatment but also in accordance with any increase in caesarean section rate. Available methods to control postpartum haemorrhage depend on the cause but in general delaying diagnosis and treatment may lead to a life threatening situation. Five percent of vaginal deliveries may lead to postpartum haemorrhage with a blood loss > 1 L3. The common causes include uterine atony, lower genital tract lacerations, retained placenta and placental fragments, coagulopathy, uterine inversion and ruptured uterus9. These causes can individually or collectively lead to life threatening situations.Published data suggest a variety of acceptable methods of treatment such as simple bi-manual compression, ecbolics such as oxytocins, syntometrine and prostaglandins which are safe and effective but occasionally prove inadequate or unsatisfactory. Surgical methods vary depending on the site of bleeding, the severity of the condition and the cardiovascular stability of the patient. Various surgical methods to reduce pelvic pulse pressure have been described, from simple surgical ligature of the uterine artery to more complicated uterine, ovarian and internal iliac artery ligature3*'. These procedures need skill which may not normally be possessed by the duty Registrar faced with such problems in the middle of the night. Probably some Consultants have never done such complicated procedures because of the relative rarity of this emergency obstetric problem.We describe an innovative method which is simple and effective, tried and tested with a successful outcome for the control of life threatening postpartum haemorrhage, as an alternative to more complicated surgery including hysterectomy. Description of techniqueThe following steps are involved in the competent application of the B-Lynch suturing technique:1. The patient under general anaesthesia is catheterised and placed in the Lloyd Davies position for acces...

One of the principal goals of spectral theory for operators is to find unitary invariants which are local relative to the spectrum. Multiplicity theory provides a complete set of such invariants for normal operators on (complex) Hilbert space. For general operators on finite-dimensional Hilbert space a nilpotent operator is attached to each point of the spectrum and these "local operators" together with their relative location provide a complete set of unitary invariants. In this note we announce analogous results for a class of operators whose characteristic property is having an open set of eigenvalues. Included in this class are the backward shift together with the adjoint of various subnormal, hyponormal, and weighted shift operators. Although our goal is to provide a systematic spectral theoretic approach to the study of this type of operator, here we are concerned only with a result on unitary equivalence.For 12 a connected open subset of C and n a positive integer, let B"(12) denote the (bounded linear) operators T defined on the separable Hilbert space H which satisfy: (1) 12 is contained in the spectrum o(T); (2) (r-co)ff = H for co in 12; (3) dim ker(r-co) = n for co in 12; and (4) V w e«ker(!T-co) = H. To study T in B w (12) we introduce the "local operators" N^ on W w defined for each co in 12, where W w = ker(!T-co) fI + 1 and N^ = (2T-co)|N w . Observe that N u is nilpotent of order n + 1 on a space of dimension n(n 4-1). Our principal result is THEOREM 1. Operators T and T r in B"(!2) are unitarily equivalent if and only ifN^ is unitarily equivalent to N'^ for co in 12.REMARKS. (1) For n = 1 the real analytic function tr N^N*^ is a complete set of unitary invariants. In general, the complete set of unitary invariants can be chosen to be real analytic functions defined as the traces of a finite number of words in N^ and N*^.(2) For "generic operators" one need only consider (T-co)|ker(f -co) 3 . (3) Comparatively trivial results obtain if one allows knowledge of either (J-co)|ker(r-co)* or riN/f^ke^r-co f ) with co 1? co 2 , . . . , co k in 12 for arbitrary k. AMS (MOS) subject classifications (1970). Primary 47A10, 47B20, 53B3S.

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