Fertility after “only B-Lynch” suture: A case report and literature review

Gerli, Sandro; Favilli, Alessandro; Giordano, Claudia; Pericoli, Silvia; Laurenti, Elena; Renzo, Gian Carlo Di

doi:10.1016/j.tjog.2013.01.014

Cited by 11 publications

(11 citation statements)

References 17 publications

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“…The B-Lynch suture is usually performed to control postpartum hemorrhage caused by uterine atony during cesarean delivery ( 25 , 26 ). Case reports have described the uterine adhesions secondary to B-Lynch sutures; however, evidence-based data are unavailable to confirm the fertility and pregnancy outcomes in patients who underwent the B-Lynch suture for postpartum hemorrhage ( 27 ). Therefore, B-Lynch suture used during cesarean delivery warrants cautions in patients who desire fertility preservation treatment.…”

Section: Discussionmentioning

confidence: 99%

Role of Abdominal Aortic Balloon Placement in Planned Conservative Management of Placenta Previa With Placenta Increta or Percreta

Chu

Wang

et al. 2021

Front. Med.

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Background: We investigated the role of balloon placement in the abdominal aorta (BPAA) in planned conservative management of placenta previa with placenta increta or percreta and the effects of BPAA on perinatal adverse maternal events.Methods: This retrospective case-control study included women with placenta previa (increta or percreta), who underwent pregnancy termination at the Qilu Hospital of Shandong University between January 2016 and June 2019. Patients were categorized into the BPAA and non-BPAA groups based on the BPAA placement before delivery. The Chi-square and non-parametric rank-sum tests were used for the intergroup comparison of patient characteristics. The propensity score matching algorithm was used to minimize the intergroup differences in clinical characteristics. Logistic regression analysis was used to identify the factors associated with a high risk of adverse pregnancy outcomes. The area under the receiver operating characteristic curve [area under the curve (AUC)] was used to evaluate the classification of the selected high-risk factors.Results: The study included 260 patients, and 104 patients were identified after propensity score matching. In the post-matched cohort, intraoperative blood loss was significantly lower in the BPAA than in the non-BPAA group (median 1,000 vs. 2,250 ml, P < 0.001). Intraoperative B-Lynch suture was performed in fewer patients in the BPAA (15.4 vs. 34.6%, P = 0.024) than in the non-BPAA group. The packed red blood cell (PRBC) transfusion rate was lower in the BPAA group (median 4 vs. 8 units, P < 0.001). Overall, 46 (45.1%) patients developed adverse maternal events; however, the rate of adverse maternal events was lower in the BPAA group (19.6 vs. 80.4%, P < 0.001). No ligation of the ascending branch of the uterine artery (P = 0.034), no BPAA (P < 0.001), intraplacental vascular lacunae (P = 0.046), and cervical hypervascularity (P = 0.001) were associated with a high risk of adverse perinatal maternal events. The AUC of the high-risk factors was 0.89 in the post-matched and 0.76 in the pre-matched cohorts.Conclusion: Planned conservative management using BPAA significantly minimized the intraoperative blood loss, the need for a B-Lynch suture, and PRBC transfusion in patients with severe placenta accreta spectrum and placenta previa.

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Section: Discussionmentioning

confidence: 99%

Role of Abdominal Aortic Balloon Placement in Planned Conservative Management of Placenta Previa With Placenta Increta or Percreta

Chu

Wang

et al. 2021

Front. Med.

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“…Obstetric hysterectomy is the definitive management. Compression suture like B-Lynch suture and its modifications are conservative surgical modalities for preserving future fertility in the management of atonic PPH [2]. B-Lynch and colleagues in 1997 described this surgical technique.…”

Section: Discussionmentioning

confidence: 99%

B-Lynch Resulting in Total Uterine Necrosis Leading to Obstetric Hysterectomy

Mishra

Dash

Rath

2017

J Obstet Gynecol India

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“…There are isolated cases that have reported successful pregnancies after B-Lynch suture, 25,26 but currently no studies have adequately assessed fertility after uterine compression suturing. Some authors have alerted surgeons to possible hidden mid-or long-term effects of uterine compression sutures and have suggested a systematic follow-up of a relatively large cohort.…”

Section: Discussionmentioning

confidence: 99%

Removable uterine compression sutures for postpartum haemorrhage

et al. 2014

BJOG

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In 1997, B-Lynch and colleagues introduced the B-Lynch uterine compression suture for postpartum haemorrhage. Since then, various uterine compression sutures have been used and postpartum hysterectomy has been avoided in many women. However, some complications have emerged in years. In this article we discuss two types of uterine compression sutures in which stitches can be removed. The procedures have been successfully applied with no problems and no observed complications to date. This is a novel concept, with the potential to reduce morbidity related to compression sutures, but needs further evaluation.

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Fertility after “only B-Lynch” suture: A case report and literature review

Abstract: The B-Lynch hemostatic surgical procedure, alone, does not seem to have a negative impact on fertility. Additional clinical evidences in a greater case-series of patients are needed to assess the value of the method for fertility preservation.

Cited by 11 publications

References 17 publications

Role of Abdominal Aortic Balloon Placement in Planned Conservative Management of Placenta Previa With Placenta Increta or Percreta

Role of Abdominal Aortic Balloon Placement in Planned Conservative Management of Placenta Previa With Placenta Increta or Percreta

B-Lynch Resulting in Total Uterine Necrosis Leading to Obstetric Hysterectomy

Removable uterine compression sutures for postpartum haemorrhage

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