Uterine necrosis in a case of B-Lynch brace suture

Meena N. Satia, Vibha S. More


B Lynch is a conservative surgical procedure for Atonic PPH not responding to medical line of treatment very few complications of this procedure have been reported. We describe B-Lynch suture erosion through the uterine wall identified on 16 day postpartum. A 24 year old primigravida underwent a primary low transverse cesarean section at term indication being primigravida with breach presentation intra-operatively there was torrential blood loss and uterus remained flabby despite treatment with uterotonics drugs delayed absorbable suture was used to place B-Lynch suture for control of the hemorrhage and had sepsis for which she had to undergo obstetric hysterectomy.

Full Text:



Kwast BE. Postpartum haemorrhage: its contribution to maternal mortality. Midwifery. 1991;7:64-70.

Ghodake VB, Pandit SN, Umbardand SM. Role of modified B-lynch suture in modern day management of atonic postpartum haemorrhage. Bombay Hospital Journal. 2008;50(2):205-11.

World health organisation. Maternal mortality: a global factbook. Geneva, WHO; 1991.

Sentilhes L, Gromez A, Razzouk K, Resch B, Verspyck E, Marpeau L. B-Lynch suture for massive persistent postpartum hemorrhage following stepwise uterine devascularization. Acta Obstet Gynec Scand. 2008;87(10):1020-6.

Arduini M, Epicoco G, Clerici G, Bottaccioli E, Arena S, Affronti G. B-Lynch suture, intrauterine balloon, and endouterine hemostatic suture for the management of postpartum hemorrhage due to placenta previaaccreta. Int J Gynaecol Obstet. 2010;108:191-3.

Obstetric haemorrhage Williams obstetrics 22nd edition, McGraw-Hill Medical Publication division; 2005:823-24.

Condous GS, Arulkumaran S. Medical and conservative surgical management of postpartum hemorrhage. J Obstet Gynaecol Can. 2003;25:931-6.

B-Lynch C, Coker A, Lawal AH, Abu J, Cowen MJ. The B-Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported. Br J Obstet Gynaecol. 1997;104:372-5.

Joshi VM, Shrivastava M. Partial ischemic necrosis of the uterus following a uterine brace compression suture. BJOG. 2004;111:279-80.

Ochoa M, Allaire AD, Stitely ML. Pyometria after hemostatic square suture technique. Obstet Gynecol. 2002;99:506-9.

Treloar EJ, Anderson RS, Andrews HS, Bailey JL. Uterine necrosis following B-Lynch suture for primary postpartum haemorrhage. BJOG. 2006;113:486-8.

Bhal K, Bhal N, Mulik V, Shankar L. The uterine compression suture a valuable approach to control major haemorrhage at lower segment caesarean section. J Obstet Gynaecol. 2005;25:10-4.

Cho JH, Jun HS, Lee CN. Hemostatic suturing technique for uterine bleeding during cesarean delivery. Obstet Gynecol. 2000;96:129-31.

Ghezzi F, Cromi A, Uccella S, Raio L, Bolis P, Surbek D. The Hayman technique: a simple method to treat postpartum haemorrhage. BJOG. 2007;114:362-5.

Hayman RG, Arulkumaran S, Steer PJ. Uterine compression sutures: surgical management of postpartum hemorrhage. Obstet Gynecol. 2002;99:502-6.

Pereira A, Nunes F, Pedroso S, Saraiva J, Retto H, Meirinho M. Compressive uterine sutures to treat postpartum bleeding secondary to uterine atony. Obstet Gynecol. 2005;106:569-72.