Objectives : to determine the efficacy of B - Lynch suture in primary pph during caesarean with failed medical management, thereby decreasing the need for hysterectomy and preserving subsequent fertility and menstrual function Methods : study of 20 cases with uterine atony and subsequent pph during caesarean in vani vilas hospital during sept.2007 to sept.2008. Inclusion criteria : Cases posted for caesarean which resulted in uterine atony and subsequent pph,where conventional uterotonics proved ineffective in controlling pph are used as subjects for study.