Efficacy of Bilateral Uterine Artery Ligation Versus Uterine Fixation Suture (Modified B-Lynch) in Treatment of Atonic Post-Partum Hemorrhage

Background: One of the significant obstetrical crises that can turn a typical physiological labor and delivery process into a potentially fatal situation in a matter of minutes is post-partum hemorrhage (PPH). Aim and objectives: To aid in lowering the incidence of maternal morbidity and death due to atonic PPH. Patients and methods: One hundred patients with a high risk of atonic PPH who presented with PPH (blood loss of 1000 ml) to the Obstetrics and Gynecology Department at Al-Hussein University Hospital and Ismailia Medical Complex between November 2021 and October 2022 were the subjects of a prospective comparison study. Two groups of patients were formed: Group A: B lynch sutures and medical care were provided to 50 patients. Group B: 50 individuals received medication and bilateral uterine artery ligation. Results: Causes of PPH were insignificantly different between the studied groups. Both groups have a similar proportion of multiparity (40%), while Group B has a slightly higher incidence of anemia (24%) compared to Group A (20%). Group A shows a higher occurrence of polyhydramnios (12%) compared to Group B (8%), while chorioamnionitis and prolonged delivery rates are comparable between the two groups. Notably, both groups have a low incidence of multiple pregnancies (4%), and differences in macrosomic baby rates are minimal, with Group A at 8% and Group B at 6%. Conclusion: Both bilateral uterine artery ligation and B-Lynch sutures, when used in conjunction with medical treatment, are similarly effective in managing atonic PPH. The choice between these two techniques may depend on the individual patient's clinical condition, surgeon's expertise, and resource availability.