Efficient modification of B-lynch brace suture for management of postpartum hemorrhage in developing countries: a report of two cases

TL;DR

A modified suture technique is used to manage postpartum hemorrhage in resource-limited settings, successfully preserving the uterus and enabling future pregnancies.

Contribution

A novel suture modification using locally available needles and sutures is introduced for managing postpartum hemorrhage in developing countries.

Findings

The modified suture technique effectively controlled postpartum hemorrhage in two cases.

The modification allowed successful penetration of the uterine muscle using a straight needle.

The technique resulted in good prognosis and subsequent successful pregnancies.

Abstract

Uterine compression suture is an alternative choice for managing postpartum hemorrhage and preserving the uterus. However, the required sutures and needles may not be available in developing countries. The 70 mm round-bodied needle was not available in our country. Therefore, we used a 60 mm straight needle mounted to a No. 2/0 Nylon suture and a 40 mm round-bodied needle mounted to a No. 2 Vicryl suture. The free ends were tied effectively with three knots to ensure stability, and the straight needle was used to penetrate the uterus. By using this modification, we took advantage of the length of the straight needle to pass through the uterine muscle at every entry/exit point, which was something that could not be achieved by the small, round-bodied needle (40 mm) available in our hospital. Our modification showed a good prognosis and subsequent successful pregnancy.

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