• Ansa Islam Department of Gynaecology, Ayub Medical College, Abbottabad
  • Salma Rehman Department of Gynaecology, Ayub Medical College, Abbottabad
  • Anisa Fawad Department of Gynaecology, Ayub Medical College, Abbottabad
  • Humaira Jadoon Department of Gynaecology, Ayub Medical College, Abbottabad
  • Shehla Noor Department of Gynaecology, Ayub Medical College, Abbottabad
  • Maryam Bibi Department of Gynaecology, Ayub Medical College, Abbottabad




B.lynch, Primary PPH, B.lynch during C-section


Background: The most common cause of post partum hemorrhage after a cesarean section is uterine atony. The main aim of this study was to examine the outcomes of the B-Lynch procedure in patients who experienced primary PPH after cesarean section. Methods: This study spanned one year, from August 2020 to August 2021, at Ayub Teaching Hospital. Patients who developed post-partum hemorrhage after a cesarean section were enrolled in this study and a thorough review of their records was conducted to identify those who received B-Lynch sutures and assess the resulting outcomes. Results: Out of the 87 patients who experienced PPH, 24 (27.6%) patients received the B-Lynch procedure. Among these 24 patients, only two (8.3%) needed hysterectomy, while the remaining 22 successfully recovered after receiving the B-Lynch procedure. Conclusion: The B-Lynch technique proves to be a safe, effective, and easily applicable method for stopping hemorrhage in patients who experienced significant initial postpartum hemorrhage due to uterine atony


Alkema L, Chou D, Hogan D, et al; United NationsMaternalMortality Estimation Inter-Agency Group collaborators and technical adviso ry group. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Lancet. 2016;387 (10017):462-474.

Song H, Hu K, Du X, Zhang J, Zhao S. Risk factors, changes in serum inflammatory factors, and clinical prevention and control measures for puerperal infection. J Clin Lab Anal. 2020;34(03):e23047.

Zheng J, Xiong X, Ma Q, Zhang X, Li M. A new uterine compression suture for postpartum haemorrhage with atony. BJOG. 2011;118(3):370–4.

Combs CA, Murphy EL, Laros RK., Jr Factors associated with postpartum hemorrhage with vaginal birth. Obstet Gynecol. 1991;77(1):69–76.

Prasertcharoensuk W, Swadpanich U, Lumbiganon P. Accuracy of the blood loss estimation in the third stage of labor. Int J Gynaecol Obstet. 2000;71(1):69–70.

Studd J. Progress in Obstetrics and Gynecology. 1st ed. Vol. 17. London: Churchill Livingstone; 2007. p. 472.

B-Lynch C, Coker A, Lawal AH, Abu J, Cowen MJ. The B-Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported. Br J Obstet Gynaecol. 1997;104(3):372–5.

World Health Organisation. WHO guidelines for the management of postpartum haemorrhage and retained placenta [Internet] Geneva (CH): World Health Organisation: [2023 June 15; ]. Available from: https://apps.who.int/iris/bitstream/handle/10665/44171/9789241598514_eng.pdf?sequence=1

Gerli S, Favilli A, Giordano C, Pericoli S, Laurenti E, Di Renzo GC. Fertility after "only B-Lynch" suture: a case report and literature review. Taiwan J Obstet Gynecol. 2013;52(1):110–2.

WHO guidelines for the management of postpartum haemorrhage and retained placenta. Geneva: World Health Organisation; 2009.Available from: https://www.ncbi.nlm.nih.gov/books/NBK148662/

Grotegut CA, Larsen FW, Jones MR, Livingston E. Erosion of a B-Lynch suture through the uterine wall: a case report. J Reprod Med. 2004;49(10):849–52.

Bagade PM. Efficacy of B-Lynch compression suture for control of intractable hemorrhage during cesarean section. MGM J Med Sci. 2022;9(3):345–50.

Nalini N, Kumar A, Prasad MK, Singh AV, Sharma S, Singh B, et al. Obstetric and maternal outcomes after B-Lynch compression sutures: A meta-analysis. Cureus. 2022;14(11):e31306.

Waheed SS. Dilawakar kazmi MN, Naeem S. A descriptive study to evaluate the role of B-Lynch suture in controlling primary post partum haemorrhage (PPH). Pak J Med Health Sci. 2017;11(1):100–1.

Hackethal A, Brueggmann D, Oehmke F, Tinneberg HR, Zygmunt MT, Muenstedt K. Uterine compression U-sutures in primary postpartum hemorrhage after Cesarean section: fertility preservation with a simple and effective technique. Hum Reprod. 2008;23(1):74–9.

Pal M, Biswas AK, Bhattacharya SM. B-Lynch brace suturing in primary post-partum hemorrhage during cesarean section. J Obstet Gynaecol Res. 2003;29(5):317–20.

El-Hamamy E, B-Lynch C. A worldwide review of the uses of the uterine compression suture techniques as alternative to hysterectomy in the management of severe post-partum haemorrhage. J Obstet Gynaecol. 2005;25(2):143–9.

El-Hamamy E, Wright A, B-Lynch C. The B-Lynch suture technique for postpartum haemorrhage: a decade of experience and outcome. J Obstet Gynaecol. 2009;29(4):278–83.

Mallappa Saroja CS, Nankani A, El-Hamamy E. Uterine compression sutures, an update: review of efficacy, safety and complications of B-Lynch suture and other uterine compression techniques for postpartum haemorrhage. Arch Gynecol Obstet. 2010;281(4):581–8.

Doumouchtsis SK, Papageorghiou AT, Arulkumaran S. Systematic review of conservative management of postpartum hemorrhage: what to do when medical treatment fails. Obstet Gynecol Surv. 2007;62(8):540–7.

Vachhani M, Virkud A. Prophylactic B-Lynch suture during emergency caesarean section in women at high risk of uterine atony: a pilot study. Internet J Gynecol Obstet. 2006;7(1):1–5.

Kalkal N, Sarmalkar MS, Nayak AH. The effectivreness of B-Lynch sutures in management of atonic postpartum hemorrhage during cesarean section. Int J Reprod Contracept Obstet Gynecol. 2010;5(9):2915–20.

Tariq S, Wazir S, Moeen G. Efficacy of B-Lynch brace suture in postpartum haemorrhage. Ann King Edw Med Univ. 2011;17(2):116.

Koh E, Devendra K, Tan LK. B-Lynch suture for the treatment of uterine atony. Singapore Med J. 2009;50(7):693–7.

Allahdin S, Aird C, Danielian P. B-Lynch sutures for major primary postpartum haemorrhage at caesarean section. J Obstet Gynaecol. 2006;26(7):639–42.

Warade S, Sharma N. A Prospective study of B-Lynch suture in the management of atonic PPH at tertiary care centre. Indian J Obstet Gynaecol Res. 2020;7(2):173–6.

Nalini N, Kumar SJ. B-Lynch suture - An experience. J Obstet Gynaecol India. 2010;60:128–34.

Shazia S, Naz S, Shaikh A, Parveen R, Soomro N. B-Lynch suture in the management of massive postpartum hemorrhage. Rawal Med J. 2013;38(4):404–8.

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