B-Lynch Hemostatic Suture in the Control of Bleeding Due to Uterine Atony Refractory to Conventional Treatment

Abstract

Introduction: Postpartum hemorrhage continues to be one of the main causes of maternal death in the world despite the advances made in its management. The causes that produce it include uterine atony, trauma, lacerations, retention of products of conception and coagulation disorders.
Objective: To establish the control of postpartum hemorrhage caused by uterine atony, using the conservative surgical technique called B-Lynch sutures.
Case report: A 29-year-old puerperal woman, with 4 pregnancies (previously, 2 deliveries and 1 induced abortion), assisted at Ramón González Coro Gyneco-obstetric Hospital in Havana, Cuba, had her delivery by cesarean section at 40.1 weeks of gestation, due to prolapse of the cord in December 2020. She had abundant bleeding during the intraoperative period, consequently, uterine massage was performed and uterotonics was used but they did not solve the bleeding. It was decided to perform a conservative technique with B Lynch sutures and it was successfully possible to control postpartum hemorrhage and preserve the uterus. The patient evolved with no complications for 8 days, complying with the antibiotic protocol in the surgical puerperium room, at which point she was
discharged and followed up in the outpatient clinic.
Conclusions: Hemorrhage control using the conservative B Lynch suture technique was successful in this patient with atony refractory to conventional drug treatment.