David B.,Sree Sree Balaji Medical College and Hospital |
Shashikala,Sree Sree Balaji Medical College and Hospital |
Saraswathi K.,Sree Sree Balaji Medical College and Hospital
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2014
Postpartum hemorrhage (PPH) is an obstetrical emergency and one of the leading causes of maternal mortality. It can be managed with conservative methods, the failure of which often mandates surgical intervention. Hysterectomy is the last resort. The B-Lynch sutures have been widely used in cases where conservative methods fail and to prevent hysterectomy thereby maintaining the fertility. Here we describe a case of a healthy 25-year-old woman, primi gravida, who underwent Caesarean section at 39 weeks 2days gestation after failure to progress in labour. To control intractable atonic postpartum hemorrhage B-Lynch sutures were applied. Patient developed fever and abdominal distension. MRI revealed subinvolution and ischaemic necrosis of the uterus. Laparotomy proceeded with Subtotal hysterectomy done on 19th postoperative day. There is still a need for understanding the effectiveness and complications of the B-Lynch sutures, though it is a simple and easy technique which effectively controls Atonic postpartum hemorrhage and maintains fertility. It is therefore encouraged to carefully follow up women with B-Lynch sutures and report failures and short term and long term consequences of B-Lynch sutures if encountered.