Clinical Experience Over 15 Years with the B-Lynch Compression Suture Technique in the Management of Postpartum Hemorrhage

Nagahama, Gilberto; Korkes, Henri Augusto; Sass, Nelson

doi:10.1055/s-0041-1735228

Cited by 5 publications

(9 citation statements)

References 28 publications

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“… The pooled proportion of hysterectomies was clinically acceptable (pooled proportion 7%, 95% CI = 4-10%). The heterogeneity was higher in this analysis (I 2 = 72.13%) [ 12 , 17 - 45 ]. …”

Section: Reviewmentioning

confidence: 78%

“…Details of included studies of B-Lynch sutures are provided in Table 1 [ 12 , 17 - 45 ]. The total number of PPH cases in which the B-Lynch suture in these 30 studies was 1,270.…”

Section: Reviewmentioning

confidence: 99%

“… Allahdin et al [ 17 ], Al Riyami et al [ 18 ], Baskett et al [ 19 ], Fuglsang et al [ 20 ], Pal et al [ 21 ], Holtesma et al [ 22 ], Jiang et al [ 12 ], Kaya et al [ 23 ], Chai et al [ 24 ], Koh et al [ 25 ], Kong et al [ 26 ], Kwong et al [ 27 ], Li et al [ 28 ], Liu et al [ 29 ], Mohamed et al [ 30 ], Neelam et al [ 31 ], Ouahba et al [ 32 ], Şahin et al [ 33 ], Sentilhes et al [ 34 ], El Sokkary et al [ 35 ], Songthamwat et al [ 36 ], Tadakawa et al [ 37 ], Zheng et al [ 38 ], Sudha et al [ 39 ], Kalkal et al [ 40 ], Tariq et al [ 41 ], Quadir et al [ 42 ], Gadappa et al [ 43 ], Ghodake et al [ 44 ], Nagahama et al [ 45 ]. …”

Section: Reviewmentioning

confidence: 99%

“… Pooled proportion of PPH controlled was 94% (95% CI = 91-97%) after the B-Lynch suture. The heterogeneity was high (I 2 = 65.3%) [ 12 , 17 - 45 ]. …”

Section: Reviewmentioning

confidence: 99%

“…FIGURE 5: Forest plot of the pooled proportion of ICU admission.The pooled proportion of ICU admissions was 21% (95% CI = 16-26%)[19,23,26,27,38,45].ICU: intensive care unit; CI: confidence interval…”

mentioning

confidence: 99%

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Obstetric and Maternal Outcomes After B-Lynch Compression Sutures: A Meta-Analysis

Nalini¹,

Kumar²,

Prasad³

et al. 2022

Cureus

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This review article aimed to determine the obstetric and maternal outcomes after B-Lynch compression sutures to control atonic postpartum hemorrhage (PPH). This meta-analysis was performed after registering the protocol in the PROSPERO database with the registration number CRD42022355358.Two independent reviewers systematically searched electronic databases and search engines (PubMed, Cochrane Library, and Google Scholar) to retrieve published articles from inception to July 2022. The obstetric and maternal outcomes after the B-Lynch compression suture were computed using the randomeffects model in pooled proportion with a 95% confidence interval (CI). Meta-regression analysis and subgroup analysis were performed to explain any source of possible heterogeneity. Quality assessment of the included studies was done using Joanna Briggs Institute (JBI) tools which are critical appraisal tools for systematic reviews and meta-analyses.This meta-analysis included a total of 30 studies involving 1,270 subjects. The pooled proportion of B-Lynch suture alone was 91% (95% CI = 82-97%). The combined proportion of B-Lynch suture plus another compression suture was 1% (95% CI = 0-3%), and the pooled proportion of B-Lynch suture plus vessel ligation was 3% (95% CI = 1-6%). The pooled proportions of PPH controlled and hysterectomies were 94% (95% CI = 91-97%, I 2 = 65.3%) and 7% (95% CI = 4-10%, I 2 = 72.13%), respectively. Therefore, B-Lynch suture (either alone or in combination with other techniques) is a simple and effective measure to control atonic PPH.

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“… The pooled proportion of hysterectomies was clinically acceptable (pooled proportion 7%, 95% CI = 4-10%). The heterogeneity was higher in this analysis (I 2 = 72.13%) [ 12 , 17 - 45 ]. …”

Section: Reviewmentioning

confidence: 78%

“…Details of included studies of B-Lynch sutures are provided in Table 1 [ 12 , 17 - 45 ]. The total number of PPH cases in which the B-Lynch suture in these 30 studies was 1,270.…”

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

“… Pooled proportion of PPH controlled was 94% (95% CI = 91-97%) after the B-Lynch suture. The heterogeneity was high (I 2 = 65.3%) [ 12 , 17 - 45 ]. …”

Section: Reviewmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Obstetric and Maternal Outcomes After B-Lynch Compression Sutures: A Meta-Analysis

Nalini¹,

Kumar²,

Prasad³

et al. 2022

Cureus

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Challenges and diagnosis in therapy of secondary amenorrhoea in caesarean section patient with postpartum haemorrhage B-lynch sutures: a case report

Harzif,

Nurbaeti,

Andyra

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and importance: FIGO (International Federation of Gynecology and Obstetrics) and WHO (World Health Organization) report the incidence of postpartum hemorrhage (PPH) reaches 1-10% and contributes to an increase in postpartum maternal mortality with uterine atony as the most common cause. B-Lynch method is a suturing technique to overcome PPH. Athough this method has proven useful as an emergency life-saving measure, the post-procedure complications are still able to occur. Presentation of case: The patient was not menstruating for 14 months after giving birth through caesarean section with B-Lynch due to PPH. Before pregnancy, she had regular menstruation cycle and normal menstrual duration. Her general and gynecological status were normal. Ultrasound showed the impression of uterine hypoplasia and endometrium that were difficult to assess while both ovaries were normal. Diagnostic hysteroscopy showed a severe degree of Asherman’s syndrome. The results of FSH, LH and estradiol were normal. Discussion: B-lynch suture is performed as a method to stop PPH in uterine atony. Secondary amenorrhea occurs as a complication of B-lynch. Compression action of B-lynch can cause progressive myometrium necrosis resulting in synechiae and blockade of uterine blood flow. This will interfere with the development of the uterus. Intrauterine adhesions and amenorrhea with normal levels of FSH, LH, and estradiol support the diagnosis of Asherman’s syndrome. Conclusion: Our case shows that the B-Lynch procedure, which is the worldwide recommended method for treating postpartum hemorrhage due to its high success rate, can cause complications of Asherman’s syndrome and cause secondary amenorrhea.

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A new step-wise surgical technique of knapsack-like uterine compression sutures for intractable postpartum hemorrhage in cesarean section

Han,

Zhang,

et al. 2024

BMC Pregnancy Childbirth

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Background Intractable postpartum hemorrhage (PPH) during cesarean section has been a significant concern for obstetricians. We aimed to explore the effectiveness and safety of a new type of uterine compression suture, the step-wise surgical technique of knapsack-like sutures for treating intractable PPH caused by uterine atony and placenta factors in cesarean section. Methods The step-wise surgical technique of knapsack-like sutures was established on the basis of the artful combination of vertical strap-like sutures and an annular suture-ligation technique. This novel surgical technique was applied to 34 patients diagnosed with PPH during cesarean section due to severe uterine atony and placental factors in our department. The hemostatic effects, clinical outcomes and follow-up visit results were all reviewed and analyzed. Results This new uterine compression suture successfully stopped bleeding in 33 patients, and the effective rate was 97.06%. Only 1 patient failed and was changed to use bilateral uterine arterial embolization and internal iliac artery embolization. The follow-up visits indicated that 33 patients restored menstruation except for 1 who was diagnosed with amenorrhea. The gynecological ultrasound tests of all the patients suggested good uterine involutions, and they had no obvious complaints such as hypogastralgia. Conclusions This step-wise surgical technique of knapsack-like uterine compression sutures can compress the uterus completely. It is a technique that can conserve the uterus and fertility function without special equipment in caesarean section for PPH, with the characteristics of being safe, simple and stable (3 S) with rapid surgery, reliable hemostasis and resident doctor to operation (3R).

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Clinical Experience Over 15 Years with the B-Lynch Compression Suture Technique in the Management of Postpartum Hemorrhage

Cited by 5 publications

References 28 publications

Obstetric and Maternal Outcomes After B-Lynch Compression Sutures: A Meta-Analysis

Obstetric and Maternal Outcomes After B-Lynch Compression Sutures: A Meta-Analysis

Challenges and diagnosis in therapy of secondary amenorrhoea in caesarean section patient with postpartum haemorrhage B-lynch sutures: a case report

A new step-wise surgical technique of knapsack-like uterine compression sutures for intractable postpartum hemorrhage in cesarean section

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