Application of uterine compression suture in association with intrauterine balloon tamponade (‘uterine sandwich’) for postpartum hemorrhage
Open accessAbstract
We evaluated in a prospective observational study the use of a ‘uterine sandwich’ technique (uterine compression sutures in association with intrauterine tamponade) in women who had had unsuccessful medical treatment for postpartum hemorrhage. Ten of the 11 patients had cesarean sections (complicated by placenta previa and uterine atony) and one had a normal delivery. The median estimated blood loss and units of blood transfused were 1500ml (range 750–4000ml) and two units (range 0–9), respectively. B‐Lynch sutures were placed in two patients and Hayman's modification was used in nine. Bakri balloon tamponade was in place for a median of 22hours (range 17–27hours), while the median volume infused in the balloon was 300ml (range 150–350ml). The combined technique was successful in avoiding hysterectomy in all cases, and there was no documented postpartum morbidity. This is a simple and quick surgical technique that can be used to treat atonic postpartum hemorrhage, particularly in conjunction with placenta previa.
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A combined method of B-Lynch suture and intrauterine balloon has been successfully used in preventing PPH in placenta praevia.
“A combined method of B-Lynch suture and the intrauterine balloon has also been successfully used in preventing PPH in placenta praevia.105”
From Placenta Praevia and Placenta Accreta: Diagnosis and Management: Green‐top Guideline No. 27a (2019) · cites this paper as [105]
The Results (page unavailable) report that the combined suture-and-balloon procedure controlled bleeding without further surgery; 10 of 11 women had placenta previa, and two received B-Lynch sutures. But these women generally already had postpartum hemorrhage, and the Discussion (page unavailable) describes only one prophylactic use to prevent further bleeding. The paper therefore supports successful treatment in this setting, not the broader claim that B-Lynch plus balloon prevented PPH. (LLM, conf=0.88)
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References 18 · Cited by 83
Research works printed but not linked: 3
- [1]1. Lewis G (ed.). Saving mothers' lives: reviewing maternal deaths to make motherhood safer 2003-2005. The Seventh Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. London: CEMACH, 2007.
- [4]4. Hayman RG, Arulkumaran S, Steer P. Uterine compressions sutures: surgical management of postpartum haemorrhage. Obstet Gynecol. 2002;99:502-6.
- [9]9. B-Lynch C. Conservative surgical management. In: B-Lynch C, Keith LG, Lalonde AB, Karoshi M (eds). A textbook of postpartum hemorrhage. Singapore: Sapiens Publishing, 2006. pp. 287-99.
- Authors
- YOONG, W., RIDOUT, A., MEMTSA, M., STAVROULIS, A., AREF‐ADIB, M., RAMSAY‐MARCELLE, Z., & FAKOKUNDE, A.
- Affiliations
- North Middlesex University Hospital NHS Trust (GB)
- University College London (GB)
- Venue
- Acta Obstetricia et Gynecologica Scandinavica
- Publisher
- Wiley
- Published
- 2011-05-31
- Volume
- 91
- Issue
- 1
- Pages
- 147-151
- ISSN
- 0001-6349 (ISSN-L)
- 1600-0412
- OpenAlex
- W2164024666
- Cited by
- 83
- References
- 18
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 6 · 2021: 6 · 2020: 10 · 2019: 5 · 2018: 4 · 2017: 5 · 2016: 6 · 2015: 10 · 2014: 5 · 2013: 7 · 2012: 6
- FWCI
- 6.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Acta Obstetricia Et Gynecologica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Biochemistry › Blood transfusion and management
- Health Sciences › Medicine › Hematology › Hemostasis and retained surgical items
- Keywords
- postpartum hemorrhage, uterine compression sutures, uterine balloon tamponade, Bakri balloon, B-Lynch suture, placenta previa, uterine atony, cesarean section
- MeSH terms
- Adolescent, Adult, Female, Postpartum Hemorrhage, Humans, Placenta Previa, Pregnancy, Prospective Studies, Suture Techniques, Sutures, Uterine Inertia, Treatment Outcome, Young Adult, Uterine Balloon Tamponade
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