Study of efficacy of compression suture in the surgical management of atonic PPH

Shrinivas N. Gadappa, Yogita B. Gavit, Deepika Sharma, Rasika Mahajan


Background: Study was conducted to analysis efficacy of compression suture in the surgical management of Atonic PPH. It’s prospectively carried out with 60 cases required compression suture in managing Atonic PPH. Atonic uterus is preventable cause of maternal mortality and morbidity constituting 80% PPH cases.

Methods: Prospective study carried out at tertiary care center for studying efficacy of compression suture in the surgical management of atonic PPH for one year, started after approval from ethical committee.

Results: Compression suture is effective in managing atonic PPH. out of 60 cases, 4 patient's required obstetric hysterectomy as a last resort to control Atonic PPH. Uterus was conserved in 93.3% of cases.

Conclusions: Development of compression suture technique has proved to be effective in the control of massive Atonic PPH not responding to medical management is an alternative to hysterectomy when timely applied. It proves to be valuable addition for surgical treatment of PPH and for saving uteri after medical management of PPH failed. Authors can adopt compression suture as a mid-step before resorting to uterine devascularisation or hysterectomy when medical line of management fails. Resident doctors in teaching institutes must be well trained in this technique.


Atonic PPH, Compression sutures, Devascularisation, Hysterectomy

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Arulkumaran S, Onning Tanizian. The management of postpartum haemorrhage. In: Arulkumaran, ed. The Management of Labour. 2nd ed; 2006:208-228.

DC Dutta: Complication of third stage of labour. In: Text book of Obstetrics. 7th edition. 2013:410-417.

Registrar General of India in Health Information, India. Ministry of Health. New Delhi: 2008. Available at:

Koh E, Devendra K, Tanl. B Lynch suture for the treatment of uterine atony. Singapore Meds. 2009;50(7):693-7.

Khatoon A, Hasnny SF, Ansari J. B Lynch Brace suture for the treatment of major primary postpartum hemorrhage: an experience at Abbasi Shaheed Hospital, Karachi. Med Channel. 2011;17(3):36-8.

Quahba J, Picketty M, Huel C, Azarian M. Uterine compression sutures for postpartum bleeding with uterine atony. BJOG. 2007;114(5):619-22.

Neelam N, Kumar SJ. B-Lynch suture-An experience. J Obstet Gynecol India. 2010;60(2):128-34.

Tariq S, Wazir S, Moeen G. Efficacy of B-Lynch Brace Suture in Postpartum Haemorrhage. Annals King Edward Med Univ. 2011;17(2):116.

Marasingh JP, Condous G, Seneviratne HR, Marasingh U. Modified anchored B Lynch uterine compression suture for the postpartum bleeding with uterine atony. Acta Obstret Gynecol Scand. 2011;90:280-3.

Hackethal A, Bruggmann D, Oehmke F, Tinneberg HR. Uterine compression sutures in primary PPH after Caesarean section: Fertility Preservation with a simple and effective technique. Human Reprod. 2008;23(1):74-9.

Vachhani M, Virkud A. Prophylactic B-Lynch suture during emergency caesarean section in women at high risk of uterine atony: a pilot study. Internet J Gynecol Obstet. 2006;7(1):1-8.

Majumdar A, Mallick K, Vasava B, Desai K, Dalal M. A descriptive study on Hayman suture technique to control postpartum hemorrhage. Sri Lanka J Obstet Gynaecol. 2012;34(3).

Ghodke VB, Pandit SN, Umbardand SM. Role of modified B-Lynch suture in modern day management of atonic PPH. Bombay Hospital J. 2008;50(2):205-10.

Allerhdin S, Aird C, Darielian P. B-Lynch sutures for major primary PPH at caesarean delivery. Obstet Gynecol. 2006;26(7).

Kulsange P. Assessment of efficacy of modified Balogun-Lynch stitch in management of atonic post-partum haemorrhage. Int J Biomed Adv Res. 2014;5(5).

Kalkal N, Sarmalkar MS, Nayak AH. The effectiveness of b-lynch sutures in management of atonic postpartum haemorrhage during caesarean section. Int J Reprod Contracept Obstet Gynecol. 2017;5(9):2915-20.