Uterine flexion suture: modified B-Lynch uterine compression suture for the treatment of uterine atony during cesarean section

Figures & data

Figure 1 Uterine flexion suture technique.

Notes: (1) The suture first begins at 1–2 cm below right inferior edge and 3–4 cm from the lateral border, (2) the suture is then passed to the upper incision margin 1–2 cm above and 3–4 cm from the left lateral border, (3) it is entered the posterior wall of uterus at the same level as the upper anterior entry point, (4) the suture is placed horizontally at the midline of the uterus witĥ1–2 cm depth, and (5 and 6) the needle is passed in the same fashion to the left side.

Table 1 Characteristics of patients

Characteristics	Number
Total number of patients (cases)	57
Age (years), mean ± SD (range)	27.0±7.1 (15–44)
Gestational age, mean ± SD (range)	37.5+1.9 (32–41)
Parity, n (%)
Primipara	34 (59.7)
Multipara	23 (40.3)
Indication, n (%)
Cephalopelvic disproportion	27 (47.4)
Previous cesarean section	11 (19.3)
Twin pregnancy	6 (10.5)
Fetal distress	5 (8.8)
Preeclampsia	3 (5.3)
Others	5 (8.8)
Risk factors of uterine atony, n (%)
Obesity	34 (59.7)
Induction or augmentation of labor	14 (24.6)
Prolonged labor	12 (21.1)
Multifetal pregnancy	6 (10.5)
Received magnesium sulfate	6 (10.5)
Others	6 (10.5)
Uterotonic agents used, n (%)
Oxytocin	57 (100)
Methylergonovine maleate (Methergin^®)	47 (82.5)
Sulprostone (Nalador^®)	37 (64.9)

Table 2 Results of treatment

Results	Cases
Uterine preservation, n (%)	57 (100)
Estimated blood loss (mL), mean ± SD (range)	468.4±274.5 (200–1,500)
Estimated blood loss >500 mL, n (%)	14 (24.6)
Postpartum hemorrhage (>1,000 mL), n (%)	5 (8.8)
Complication, n (%)
Febrile morbidity	5 (8.8)
Fertility after procedure, n (%)
Tubal resection	22 (38.6)
Contraception	13 (22.8)
Pregnancy	4 (7.0)
No pregnancy	9 (15.8)
Loss to follow-up	9 (15.8)