A Surgical Procedure for Postpartum Hemorrhage

A 24 minute video of an important and increasingly widely used surgical option
by Professor Christopher B-Lynch, Milton Keynes Hospital NHS Foundation Trust, UK

The B-Lynch suturing technique (brace suture) may be particularly useful because of its simplicity of application, life saving potential, relative safety, and its capacity for preserving the uterus and thus fertility. Satisfactory hemostasis can be assessed immediately after application. If it fails, other more radical surgical methods as mentioned in this paper and in the literature can be considered. The special advantage of this innovative technique is an alternative to major surgical procedures to control pelvic arterial pulse pressure or hysterectomy. This suturing technique has been successfully applied with no problems to date and no apparent complications if competently applied.

Postpartum hemorrhage is a serious obstetric problem. Life threatening postpartum hemorrhage can be a nightmare. Current clinical methods are unsuitable for the objective assessment of postpartum hemorrhage, and each patient's ability to compensate varies considerably. There are no reliable data on the true incidence of severe life threatening postpartum hemorrhage. The morbidity and mortality rise not only with delay in diagnosis and treatment but also in accordance with any increase in cesarean section rate. Available methods to control postpartum hemorrhage depend on the cause but in general delaying diagnosis and treatment may lead to a life threatening situation. Five per cent of vaginal deliveries may lead to postpartum hemorrhage with a blood loss >1L. The common causes include uterine atony, abnormal placentation, lower genital tract lacerations, retained placenta and placental fragments, coagulopathy, uterine inversion and ruptured uterus. These causes can individually or collectively lead to life threatening situations - CBL