When do you use B-Lynch sutures?
The B-Lynch suture or B-Lynch procedure is a form of compression suture used in obstetrics. It is used to mechanically compress an atonic uterus in the face of severe postpartum hemorrhage.
What is the first line used to treat uterine atony?
External uterine massage and bimanual compression are generally used as first-line treatments. These compression techniques encourage uterine contractions that counteract atony and assist with expulsion of retained placenta or clots.
What is the most effective medication treatment for uterine atony and PPH?
Medications used for postpartum hemorrhage secondary to Uterine atony include the following: Oxytocin (Pitocin) can be given IV 10 to 40 units per 1000 ml or 10 units intramuscularly (IM). The rapid undiluted infusion may cause hypotension. Methylergonovine (Methergine) given IM 0.2 mg.
What is uterine Atony?
Atony of the uterus, also called uterine atony, is a serious condition that can occur after childbirth. It occurs when the uterus fails to contract after the delivery of the baby, and it can lead to a potentially life-threatening condition known as postpartum hemorrhage.
How is uterine atony treated?
What Is the Treatment for Uterine Atony?
- Oxytocin (Pitocin). Usually given slowly in an intravenous infusion, oxytocin stimulates the uterine muscles so they’ll contract.
- Methylergonovine (Methergine). This drug can reverse the atony and stop blood loss.
- 15-methyl-PGF2, misoprostol, and dinoprostone.
- Surgery.
What is the first line management of postpartum hemorrhage?
Oxytocin is an effective first-line treatment for postpartum hemorrhage31; 10 international units (IU) should be injected intramuscularly, or 20 IU in 1 L of saline may be infused at a rate of 250 mL per hour. As much as 500 mL can be infused over 10 minutes without complications.
How do you treat uterine atony?
How do you fix uterine atony?
Treatment for Atony of the Uterus uterine massage, which involves your doctor placing one hand in the vagina and pushing against the uterus while their other hand compresses the uterus through the abdominal wall. uterotonic drugs including oxytocin, methylergonovine (Methergine), and prostaglandins, such as Hemabate.
What type of suture is used for B Lynch?
B-Lynch is a uterine compression suture, which apposes the anterior and posterior wall through a pair of vertical brace sutures which are put around the uterus. It works by direct application of pressure on the bleeding placental bed and by reducing the blood supply to uterus.
What are compression sutures used for?
Uterine compression sutures are an effective method for the treatment of PPH, thus avoiding hysterectomy and preserving potential fertility. Postpartum hemorrhage (PPH) is an obstetric emergency that occurs in 1 to 5% of both vaginal and cesarean deliveries.
What is the management of postpartum haemorrhage?
Management of post-partum haemorrhage (PPH) involves the treatment of uterine atony, evacuation of retained placenta or placental fragments, surgery due to uterine or birth canal trauma, balloon tamponade, effective volume replacement and transfusion therapy, and occasionally, selective arterial embolization.
How do you treat postpartum hemorrhage?
Oxytocin is the most effective treatment for postpartum hemorrhage, even if already used for labor induction or augmentation or as part of AMTSL. The choice of a second-line uterotonic should be based on patient-specific factors such as hypertension, asthma, or use of protease inhibitors.
How is uterine atony related PPH treated?
Uterine atony is responsible for most cases and can be managed with uterine massage in conjunction with oxytocin, prostaglandins, and ergot alkaloids. Retained placenta is a less common cause and requires examination of the placenta, exploration of the uterine cavity, and manual removal of retained tissue.
How do you manage atonic uterus?
Treatment for Atony of the Uterus
- uterine massage, which involves your doctor placing one hand in the vagina and pushing against the uterus while their other hand compresses the uterus through the abdominal wall.
- uterotonic drugs including oxytocin, methylergonovine (Methergine), and prostaglandins, such as Hemabate.
What is the surgical management of postpartum hemorrhage?
Bilateral ligation of the uterine vessels (O’Leary stitch) is the preferred approach for controlling PPH from laceration of the uterine artery or branches of the utero-ovarian artery. If this does not control bleeding, the vessels of the utero-ovarian arcade are similarly ligated.
What suture is used on uterus?
The uterine incision is closed using an absorbable suture of number 0 or number 1. The commonly used suture materials are chromic catgut and polyglactin.
What is uterine compression sutures?
In 1997, B-Lynch et al described a highly effective surgical technique for the control of postpartum bleeding in five women with PPH: compressing the uterus with two longitudinal sutures along its long axis and preventing the uterus from relaxing and filling with blood.
Why does uterine atony cause postpartum hemorrhage?
After the placenta is delivered, these contractions help compress the bleeding vessels in the area where the placenta was attached. If the uterus does not contract strongly enough, called uterine atony, these blood vessels bleed freely and hemorrhage occurs. This is the most common cause of postpartum hemorrhage.
Is the B-Lynch suture useful for postpartum hemorrhage due to uterine atony?
Conclusion: The B-Lynch suture might be a valuable addition to the surgical treatment of postpartum hemorrhage due to uterine atony. Adolescent Cesarean Section*
What is B-Lynch suture?
B-Lynch suture is an alternative operative method for stopping postpartum hemorrhage especially in uterine atony. The chance for success of this procedure does not depend on surgical skill. With B-Lynch suture severe pressure can be achieved at the same time to both sides of uterine body.
What is the success rate of B Lynch sutures?
No short-term complications such as uterine necrosis, hematometra, pyometra, or uterine erosion related to the uterine compression suture were observed. Conclusion: Overall success rate of the B-Lynch sutures and B-Lynch sutures plus BIIAL was 75 and 94.4%, respectively.
Does the B-Lynch technique increase the risk of uterine devascularization?
The B-Lynch technique does not necessarily require specific suture material. Uterine devascularization or BIIAL did not increase the risk of the possible short-term complications such as uterine necrosis. In case of failure of the B-Lynch uterine compression sutures, BIIAL may be beneficial to save the uterus.