What is the difference between B-Lynch (Braun-Lynch) suture and Hayman suture?

From the Guidelines

The B-Lynch suture is the preferred technique for controlling postpartum hemorrhage due to uterine atony, as it has been shown to be effective in managing severe hemorrhage, especially in cases where cesarean delivery is already being performed, as noted in the management of amniotic fluid embolism 1. When considering the management of postpartum hemorrhage, it is essential to prioritize techniques that can effectively control bleeding while minimizing complications.

• The B-Lynch suture involves a continuous stitch that compresses the uterus, requiring hysterotomy, and has been used in cases of severe hemorrhage, including those associated with amniotic fluid embolism 1.
• The Hayman suture, on the other hand, is a simplified modification that does not require hysterotomy, making it faster to apply in emergency situations, but its effectiveness in severe cases may vary. Key considerations in choosing between these techniques include the severity of the hemorrhage, the need for speed, and the potential benefits of avoiding uterine incision.
• In cases where cesarean delivery is already being performed, the B-Lynch suture may be preferred due to its effectiveness in managing severe hemorrhage, as seen in the context of amniotic fluid embolism 1.
• Both techniques use absorbable sutures, such as #1 or #2 chromic catgut or Vicryl, and work by compressing the uterus to reduce blood flow and promote contraction, with reported success rates of 60-75% in preventing hysterectomy. Ultimately, the choice between the B-Lynch and Hayman sutures should be based on the specific clinical circumstances and the surgeon's preference, with the goal of effectively controlling postpartum hemorrhage and minimizing complications, as emphasized in the management of amniotic fluid embolism 1.

From the Research

B-Lynch Suture vs Hayman Suture

• The B-Lynch suture is a technique used to treat uterine atony, a common cause of postpartum hemorrhage (PPH) 2, 3, 4.
• Studies have shown that the B-Lynch suture is an effective method of containing PPH, with a high success rate in avoiding the need for hysterectomy 3, 4.
• The B-Lynch suture has been compared to other techniques, such as the Hayman suture, but there is limited information available on the Hayman suture in the context of PPH treatment.
• Other techniques, such as compressive sutures, artery ligation, and Bakri balloon tamponade, have also been used to treat PPH due to uterine atony, with varying degrees of success 5.
• The choice of technique may depend on the individual case and the expertise of the healthcare provider.

Effectiveness of B-Lynch Suture

• The B-Lynch suture has been shown to be effective in treating uterine atony, with a success rate of 72.7% in one study 3.
• Another study found that the B-Lynch modified technique was effective, safe, and rapid in treating uterine atony, with a success rate of 91.3% 4.
• The B-Lynch suture has been recommended as a technique that should be taught to all trainees and registrars in obstetrics, due to its ease of application and high success rate 3.

Comparison with Other Techniques

• The B-Lynch suture has been compared to other techniques, such as the Bakri balloon tamponade, with varying results 5.
• One study found that the combination of uterine artery ligation and B-Lynch suture with Bakri balloon tamponade may be the best surgical approach for treating PPH due to uterine atony 5.
• However, more studies are needed to determine the most effective technique for treating PPH due to uterine atony.