Efficacy of B Lynch Suture and Intrauterine Balloon Tamponade Among Women with Severe Postpartum Hemorrhage Presenting to MMC Mardan

Authors

  • Tayyaba Akhtar Mardan Medical Complex, KPK, Pakistan.
  • Sadia Mahmood Mardan Medical Complex, KPK, Pakistan.
  • Sundas Jamal Mardan Medical Complex, KPK, Pakistan.
  • Nuzhat Amin Mardan Medical Complex, KPK, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i6.1606

Keywords:

Postpartum hemorrhage, B Lynch suture, Intrauterine balloon tamponade, Obstetrics, Hemostasis

Abstract

Background: Severe postpartum hemorrhage (PPH) is a common cause of maternal morbidity and mortality and requires effective, timely interventions. Two well-known methods in the control of PPH include the B Lynch suture and the intrauterine balloon tamponade, although the comparative effectiveness between the two is yet to be determined. Objective: To compare the efficacy b lynch suture and intrauterine balloon tamponade among women with severe postpartum hemorrhage presenting to MMC Mardan. Study Design: A randomized controlled trial. Duration and Place of Study: The study was conducted from September 2024 to March 2025 at the Department of Obstetrics and Gynecology, Mardan Medical Complex, Mardan. Methodology: A total of 152 women with severe postpartum hemorrhage were enrolled and randomly assigned to either the B Lynch suture group (Group A) or the intrauterine balloon tamponade group (Group B). Demographic and clinical data were collected, and the effectiveness of each technique was evaluated based on the cessation of bleeding within 15 minutes. The primary outcomes measured included the success rate of each intervention. Results: The primary efficacy analysis revealed that the B Lynch suture was successful in 68 patients (89.5%), while intrauterine balloon tamponade succeeded in 60 patients (78.9%). However, this difference did not achieve statistical significance (p=0.075). Conclusion: While B Lynch suture demonstrated a numerically higher success rate in controlling severe postpartum hemorrhage compared to intrauterine balloon tamponade, the difference did not reach statistical significance.

Downloads

Download data is not yet available.

References

1. Bienstock JL, Eke AC, Hueppchen NA. Postpartum hemorrhage. N Engl J Med. 2021;384(17):1635-1645.

https://doi.org/ 10.1056/NEJMra1513247.

2. Anaposala S, Kalluru PKR, Calderon Martinez E, Bhavanthi S, Gundoji CR. Postpartum hemorrhage and tranexamic acid: A literature review. Cureus. 2023;15(5):e38736.

https://doi.org/10.7759/cureus.38736.

3. Hofer S, Blaha J, Collins PW, Ducloy-Bouthors AS, Guasch E, Labate F, et al. Haemostatic support in postpartum haemorrhage: A review of the literature and expert opinion. Eur J Anaesthesiol. 2023;40(1):29-38.

https://doi.org/10.1097/EJA.0000000000001744.

4. Günaydın B. Management of postpartum haemorrhage. Turk J Anaesthesiol Reanim. 2022;50(6):396-402.

https://doi.org/10.5152/TJAR.2022.21438.

5. Aimagambetova G, Bapayeva G, Sakhipova G, Terzic M. Management of postpartum hemorrhage in low- and middle-income countries: Emergency need for updated approach due to specific circumstances, resources, and availabilities. J Clin Med. 2024;13(23):7387.

https://doi.org/10.3390/jcm13237387.

6. Sadiku OD, Aina SA, Odoemene CC, Ogunmoyin TE, Adedara VO, Olasimbo O, et al. Approaches to the prevention and treatment of postpartum hemorrhage: A systematic review of past advances, recent developments, and best practices. Cureus. 2024;16(7):e65096.

https://doi.org/10.7759/cureus.65096.

7. Liu LY, Nathan L, Sheen JJ, Goffman D. Review of current insights and therapeutic approaches for the treatment of refractory postpartum hemorrhage. Int J Womens Health. 2023;15:905-926.

https://doi.org/10.2147/IJWH.S366675.

8. Kong CW, To WWK. The discriminant use of intrauterine balloon tamponade and compression sutures for management of major postpartum hemorrhage: Comparison of patient characteristics and clinical outcome. Biomed Res Int. 2021;2021:6648829.

https://doi.org/10.1155/2021/6648829.

9. 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. https://doi.org/10.7759/cureus.31306.

10. Shi C, Chen J, Chen A. Clinical outcome analysis of modified B-Lynch sutures in the fundus uteri and part of the corpus uteri for the prevention of intraoperative haemorrhage during caesarean delivery in women with twin pregnancy: A retrospective study. BMC Pregnancy Childbirth. 2023;23(1):428

https://doi.org/10.1186/s12884-023-05759-3.

11. Koirala P, Ghimire A, Bista KD. B-Lynch suture management among patients with postpartum hemorrhage in a tertiary care centre: A descriptive cross-sectional study. JNMA J Nepal Med Assoc. 2023;61(258):145-149.

https://doi.org/10.31729/jnma.8036.

12. Purandare CN, Nazareth AK, Ryan G, Purandare NC. Role of balloon tamponade as a therapeutic non-surgical tool in controlling obstetric and gynecological hemorrhage in low-resource countries. J Obstet Gynaecol India. 2022;72(4):285-290.

https://doi.org/10.1007/s13224-022-01662-7.

13. Germano C, Girlando F, Carosso AR, Messina A, Parpinel G, Leo L, et al. Uterine balloon tamponade under ultrasound guidance in women with postpartum hemorrhage: A retrospective cohort study. J Clin Med. 2024;13(9):2632.

https://doi.org/10.3390/jcm13092632.

14. Griffin KM, Oxford-Horrey C, Bourjeily G. Obstetric disorders and critical illness. Clin Chest Med. 2022;43(3):471-488.

https://doi.org/10.1016/j.ccm.2022.04.008.

15. Malik BA, Shabbir A, Saleem MM. Comparison of intrauterine balloon tamponade and B Lynch suture in severe postpartum hemorrhage. Pak Armed Forces Med J. 2018;68(6):1765-70.

16. Fatima S, Shahzadi N, Fazal S. Comparison of intrauterine balloon tamponade and B Lynch suture in severe postpartum hemorrhage. Int J Adv Biotechnol Res. 2018;9(2):188-194.

17. Syed M, Aman A, Safi S, et al. B Lynch suture and intrauterine balloon tamponade for management of severe postpartum hemorrhage: A comparative study. P J M H S. 2021;15(9):2948-2951. https://doi.org/10.53350/pjmhs211592948.

18. Malik BA, Zaib-Un-Nisa, Shabbir A, Saleem MM. Intrauterine balloon tamponade and B Lynch suture in severe postpartum hemorrhage. Pak Armed Forces Med J. 2018;68(6):1765-70.

19. Ozgen G, Aydin GA. Effectiveness of intrauterine Bakri balloon® tamponade for placenta previa and placenta accreta spectrum. J Coll Physicians Surg Pak. 2020;30(07):707-712. https://doi.org/10.29271/jcpsp.2020.07.707.

20. Akhtar KT, Tabassum S, Siddique S. Efficacy of balloon tamponade in control of primary postpartum haemorrhage (PPH). Professional Med J. 2020;27(4):717-720. https://doi.org/10.29309/TPMJ/2020.27.04.3423.

21. Zaheen Z, Akhter R, Khalid M, et al. Effectiveness of B-Lynch suture technique for treatment of high-risk women for postpartum haemorrhage at Liaquat Medical University Hospital Hyderabad. Professional Med J. 2020;27(3):523-529.

https://doi.org/10.29309/TPMJ/2020.27.3.3422.

22. Leleu A, Ghesquiere L, Machuron F, et al. Intrauterine balloon tamponade in the management of severe postpartum haemorrhage after vaginal delivery: Is the failure early predictable? Acta Obstet Gynecol Scand. 2021;98:1473-1482.

https://doi.org/10.1111/aogs.13679.

Downloads

Published

2025-06-30

How to Cite

Akhtar, T., Mahmood, S., Jamal, S., & Amin, N. (2025). Efficacy of B Lynch Suture and Intrauterine Balloon Tamponade Among Women with Severe Postpartum Hemorrhage Presenting to MMC Mardan. Indus Journal of Bioscience Research, 3(6), 908-912. https://doi.org/10.70749/ijbr.v3i6.1606