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B-Lynch brace suture

Atonic PPH where bimanual compression stops the bleeding.

Source: B-Lynch technique

Steps

  1. Lithotomy (Lloyd-Davies) to watch vaginal loss.
  2. Open uterus (re-open CS incision); empty and inspect cavity.
  3. Exteriorise; test bimanual compression — if bleeding stops, B-Lynch likely to work.
  4. No. 1–2 absorbable on a 70 mm round-bodied needle.
  5. Enter 3 cm below the lower incision edge, 3 cm from lateral border; exit 3 cm above upper edge.
  6. Over the fundus 3–4 cm from cornu; enter posterior wall horizontally at the same level.
  7. Back over the fundus on the other side; mirror anteriorly.
  8. Assistant compresses; pull taut; tie securely.
  9. Close hysterotomy; confirm vaginal bleeding controlled.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.