B-lynch

Introduction: Postpartum Hemorrhage (PPH) in Egypt Especially in Rural Area is still one of the main Causes Responsible For maternal morbidity and mortality. It still needs a radical Solution. Aim Of The Work: Evaluation of Lower Uterine Segment Post Partum Hemorrhage Management by Cervical suture, B-Lynch suture and Foley balloon and to evaluate the efficacy and safety of a novel cervical suturing technique. Patient&Methods: This study included 9860 patients in obstetric department for delivery in Banha teaching hospital. It include 30 pregnant women (primigravide and multigravide) in labour admitted to obstetric ward complaining of (PPH).This study was classified into 3 Groups .Group (I): Ten cases were managed by cervical suture in vaginal delivery with cervical tear and laceration. Group (II): Ten cases were managed by B-Lynch suture 7 of them delivered by CS & 3 of them delivered by vaginal delivery then hysterotomy was done to them. Group (III): Ten cases were managed by Foley balloon after vaginal delivery or caesarian section. Results: The mean (± SD) parity for PPH cases in this study was 1.53±1.13 times with a range of 0–7 times. The group representing primigravidas with postpartum hemorrhage was 43.3% of cases, while the group with parity ranging from 1– 4 was 50% of the PPH cases. Finally the group of cases with parity greater than 4 represented 6.7%. The treatment modalities for PPH applied in Banha teaching hospital included ecbolics, uterine massage and bimanual compression in all cases. Repair of trauma was applied in 33, 3%. Replacement with blood and blood products was done in cases with DIC which represented 3.3%, & hysterectomy was done in 3 cases as a last resort measure. Conclusion and Recommendation: The study added an evidence to confirm the world wide applicability of the cervical suturing as a method to improve the management of lower uterine segment PPH .The technique of that suture is easily learned and its popularization therefore, might be a must.