Efficacy of prophylactic B-Lynch suture in patients at high risk of antepartum hemorrhage

A research printed in Journal of Obstetrics and Gynecology Research On September 11, 2022, Kuwabara M. And so on evaluated the effectiveness of B-Lynch sutures throughout prophylactic caesarean part in girls at high risk of postpartum hemorrhage (PPH).

The B-Lynch suture was described in 1997 by the identical creator as one of the methods to deal with PPH. In 2002 the identical creator urged its prophylactic use in high-risk patients; But little has been explored in the medical literature.

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The authors developed this work primarily based on the speculation that performing this suture restrictively would scale back intraoperative blood and enhance postpartum hemorrhage.

Study

This is a retrospective observational research that included patients present process preventive cesarean part and B-Lynch suture at a Japanese tertiary medical middle between January 2019 and May 2021. A B-Lynch suture was carried out prophylactically earlier than extreme blood loss in patients with uterine atony. Placenta previa (placenta previa and low placenta), placenta accreta, thrombocytopenia, coagulopathy and different bleeding risk elements. Bleeding sutures and partial compression sutures for vaginal tamponade have been positioned if essential.

The B-Lynch suture process was carried out in 38 of 663 patients who underwent cesarean part in the course of the research interval. In addition to B-Lynch suture, partial compression suture was carried out in 30 patients and vaginal packing in 32 patients.

Of the 38 patients in whom a B-Lynch suture was utilized, 35 (92%) had no overt postoperative bleeding inside 2 hours of supply, 14 (37%) prevented blood transfusions, and didn’t bear hysterectomy. Thirty-three opposed occasions occurred in 23 patients; These included inflammatory reactions, lesions, placental retention and paralytic ileus in one, one, two and two patients respectively. In most instances, the incidents are critical and unrelated to the process. In one affected person, a second caesarean part was carried out (after 2 years) and no uterine and stomach issues have been noticed.

consequence

The authors concluded that the research findings confirmed that the B-Lynch restrictive suture was efficient. The success price, which is the speed of patients avoiding hysterectomy, was 73% to 100%.

Thus, confronted with knowledgeable scientific judgment, surgeons can use the B-Lynch suture prophylactically, resulting in safer obstetric administration. Although intraoperative blood loss is an effective indicator, early prognosis of elevated bleeding per unit of time and diploma of uterine contraction appear to be crucial elements in initiating the process.

However, additional research, particularly randomized scientific trials, are wanted to guage the prophylactic use of this process, in addition to to assist set up indication standards.

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