Abstract

The rate of life-threatening haemorrhage (blood loss 2.5 litres or more or women who received more than 5 units of blood transfusion or women who received treatment for coagulopathy after such an acute event) is estimated at 3.7/1000 maternities.1 2 Intrauterine balloon tamponade is now an appropriate first line surgical intervention for most women. The haemostatic B-Lynch brace suturing has been in use since 1997.3

The combined use of uterine compression sutures and intrauterine balloons has not been extensively reported in literature. Isolated case reports4 5 have described the successful use of balloon catheters in conjunction with a B-Lynch suture for intractable postpartum haemorrhage.

Further, there are only two case series to date describing the successful addition of a Bakri balloon when the use of a B-Lynch suture alone failed to stop uterine bleeding.6 7 In this series, one patient developed endomyometritis and a second developed postpartum oliguria.

We present a small case series of patients with a post partum haemorrhage that was managed by a combination of B-Lynch suture and Bakri Balloon at York Hospital from 2006–2011. The clinical backgrounds and outcomes including success rates, complications are outlined in this series from York Hospital. Although one woman proceeded to hysterectomy, we found that in the majority of patients the ‘uterine sandwich’ technique was successful and fertility was preserved.