The B-Lynch suture for control of massive hemorrhage due to postpartum uterine atony

Objective: Various invasive techniques have been used to control postpartum bleeding in patients with uterine atony refractory to medical measures. So me methods are controversial (e.g., uterine tamponade), not widely availabl e (e.g., arterial embolization), little known, or technically demanding (li gation of the uterine or internal arteries). We describe our experience wit h the suture technique described by B-Lynch in 1997. Methods: We used the B-Lynch technique in three patients with postpartum ut erine atony in an attempt to avoid hysterectomy. All patients required red cell transfusions, one developed a coagulation disorder. The B-Lynch techni que involves anchoring a running suture in the anterior and posterior aspec ts of the lower uterine segment and running the suture over the uterine fun dus in a suspender-like fashion. This apparently keeps the uterus compresse d, with subsequent reduction of uterine perfusion. Results: The B-Lynch suture required 5 to 10 minutes to perform. Bleeding d eclined markedly within 15 minutes and no patient required hysterectomy. Conclusion: The small number of cases reported to date suggest that the B-L ynch suture is a straightforward and efficient technique to control severe bleeding due to postpartum uterine atony.