KUMJ | VOL. 14 | NO. 1 | ISSUE 53 | JAN-MAR, 2016

Efficacy of Prophylactic B-Lynch Suture during Lower Segment Caesarian Section in High Risk Patients for Atonic Postpartum Haemorrhage
Vijayasree M

Abstract:
Background Postpartum Haemorrhage causes significant maternal mortality and morbidity all over the world. Active management of the third stage of labour with oxytocics is come into practice. If postpartum haemorrhage is anticipated conservative surgical procedures like B-lynch suture is being applied. Objective To evaluate the effect of elective B-Lynch suture in preventing atonic postpartum haemorrhage during emergency caesarian section with high risk factors for atonicity. Method Forty antenatal women undergoing emergency caesarean section with risk factors for atony of the uterus were selected in our study. Thirty five women were selected before starting Lower segment caesarian section with risk factors like general anaesthesia, chorio-amnionitis, preeclampsia, prolonged labour, second stage arrest, multiple gestation and use of magnesium sulphate. Five women were selected during the caesarean section where uterus remained atonic despite of post delivery oxytocics. Before the closure of uterus B-Lynch suture was applied. Need for additional intervention or use of blood transfusion was evaluated. The results were analysed by using appropriate statistical method. Result Seventy five percent of patients were in the age group of 18 to 23 years. Ninety percent were nulliparous and ten percent were parous women. Risk factors involved were eclampsia in 20/40 (50%), multiple gestation in 6/40 (15%), hydramnios in 6/40 (15%) and prolonged second stage of labour in 4/40 (10%) patients. Other risk factors were Chorio-amnionitis in 2/40 (5%) patients and use of magnesium sulphate in 2/40 (5%) patients causing uterine atony. The average haemoglobin level was 9.8 gms/dl. Pre and post operative haemoglobin levels differed by 0.4 to 1.8 gms/dl. There were no complications during the procedure and at three months follow up. All women resumed normal menstruation within 40 days after delivery. Conclusion Elective B-Lynch suture is cheap, quick and effective in preventing atonic Postpartum Haemorrhage in women undergoing emergency lower segment caesarian section who are at high risk for haemorrhage.
Keyword : B-lynch suture, prevention of PPH, risk Factors for PPH