A woman develops PPH after vaginal delivery. Despite uterotonics, she continues to bleed. Surgical options are escalated. The B-Lynch suture compresses the uterus by which mechanism?
- A Ligates the uterine arteries bilaterally
- B Brace suture compresses anterior and posterior walls together, reducing uterine volume and sinusoidal blood flow ✓
- C Occludes the internal iliac artery to reduce uterine perfusion pressure
- D Rotates the uterus 90 degrees to reduce inflow from ovarian vessels
Correct answer: B. Brace suture compresses anterior and posterior walls together, reducing uterine volume and sinusoidal blood flow
Explanation
The B-Lynch suture (1997) is a brace suture technique that physically compresses the uterus by placing sutures over the anterior and posterior walls, pulling them together and mechanically collapsing the uterine sinuses. This reduces uterine volume and directly tamponades bleeding by compressing the myometrial sinusoids. It is distinct from uterine artery ligation (step-down devascularization). The B-Lynch suture is a uterus-conserving procedure with reported success rates of 85–90% for atonic PPH unresponsive to medical management.
Reference: Williams Obstetrics, 26th ed.
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