Korkes H, Oliveira L G, Watanabe E, Aoki T T, Ramos C L, Nagahama G, Marques R, Negrao C, Denise V, Sass N
Obstetrícia, Maternidade Vila Nova Cachoeirinha, Sao Paulo, Brazil.
Pregnancy Hypertens. 2012 Jul;2(3):252-3. doi: 10.1016/j.preghy.2012.04.133. Epub 2012 Jun 13.
Postpartum haemorrhage is an important cause of maternal morbidity and mortality, uterine atony being responsible for most of the cases. Hypertensive disorders are supposed to increase the possibility of such complications, mainly when complicated by "abruptio placentae". The classical treatments for postpartum haemorrhage have been based on medications like oxytocin and misoprostol, but more recently a haemostatic uterine suture developed by Christopher B-Lynch has been indicated. Here, we describe our experience of performing such technique and investigate its results in patients complicated by hypertensive disorders.
Reporting a series of cases of postpartum haemorrhage treated with the B-Lynch suture.
This is a descriptive study including 39 patients treated with the B-Lynch suture after postpartum haemorrhage related to uterine atony. The period evaluated was between January 2005 and February 2012. Intravascular oxytocin was routinely used in all cases, with doses changing from 20 to 60 IU. The suture material used was chromed catgut 1.0mm.
The mode of delivery was cesarean-section in all cases. Five patients (12.8%) had hypertensive disorder as additional complication and one of these patients had abruptio placentae followed by development of Couvelaire uterus. Overall, the B-Lynch technique helped to control haemorrhage in all cases evaluated.
We believe that the B-Lynch technique appears as an important procedure to be indicated in cases of postpartum haemorrhage. Therefore, we recommend that this technique should be tried to control such complications before deciding for other more aggressive procedures like hysterectomy. It seems that this treatment may be used in patients complicated by hypertensive disorders.
产后出血是孕产妇发病和死亡的重要原因，大多数病例是由子宫收缩乏力引起的。高血压疾病被认为会增加此类并发症的可能性，主要是在并发“胎盘早剥”时。产后出血的传统治疗方法一直基于催产素和米索前列醇等药物，但最近由克里斯托弗·B-林奇开发的一种止血性子宫缝合术已被应用。在此，我们描述我们实施该技术的经验，并调查其在并发高血压疾病患者中的效果。
报告一系列用B-林奇缝合术治疗产后出血的病例。
这是一项描述性研究，包括39例因子宫收缩乏力导致产后出血后接受B-林奇缝合术治疗的患者。评估期为2005年1月至2012年2月。所有病例均常规使用血管内催产素，剂量从20国际单位到60国际单位不等。使用的缝合材料是1.0毫米的铬制肠线。
所有病例的分娩方式均为剖宫产。5例患者（12.8%）有高血压疾病作为额外并发症，其中1例患者发生胎盘早剥，随后发展为库弗莱尔子宫。总体而言，B-林奇技术在所有评估病例中都有助于控制出血。
我们认为B-林奇技术似乎是产后出血病例中一种重要的治疗方法。因此，我们建议在决定采取子宫切除术等其他更激进的手术之前，应尝试使用该技术来控制此类并发症。这种治疗方法似乎可用于并发高血压疾病的患者。
