Successful Term Pregnancy after B-Lynch Compression Suture in a Previous Pregnancy on Account of Massive Primary Postpartum Hemorrhage

Habek, Dubravko; Vranješ, Maja; Vuković, Mirna Bobić; Valetić, Josip; Krcmar, Vladimir; Simunac, Jasna

doi:10.1159/000093892

Cited by 26 publications

(17 citation statements)

References 14 publications

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“…In another study, Bhal and colloquies showed that, B-Lynch sutures were able to avoid hysterectomy 10 of 11 cases (13). In literature after uterine compression sutures, many successful pregnancies reported (14)(15)(16). One fourth of women with late first or second trimester pregnancy lost or preterm delivery were associated with uterine malformations.…”

Section: Discussionmentioning

confidence: 98%

B-Lynch suture technique to control postpartum hemorrhage in a patient with mullerian anomaly

Boyar¹,

Boynukalın²,

Boyar³

et al. 2011

J Turkish German Gynecol Assoc

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ÖzetCongenital anomalies of the uterus may cause gynecologic, obstetric and fertility problems. Obstetrical complications are reported to occur more commonly with mullerian duct anomalies, such as postpartum hemorrhage (PPH). Uterine compression sutures may be effective in controlling PPH in these conditions as an alternative to hysterectomy, especially if the patient has a desire to conceive. As the shape of the uterus is changed in congenital malformation, the usage of compression sutures such as B-Lynch can be more difficult. In this study we report a case of PPH accompanying a large septae, treated with BLynch suture. A 24 year old, multigravid and nulliparous patient (G:3) was admitted to our clinic with vaginal bleeding and abdominal pain at 31 weeks of gestation. Emergency cesarean section was performed for abruptio placenta and PPH occurred subsequently. A deep uterine septum was revealed during operation. Intermittent fundal massage and intravenous uterotonics were used to improve uterine tonicity without any improvement. After the B-Lynch suture was performed, the bleeding diminished dramatically. As the shape of the uterus is changed in congenital malformation, the application of secondary interventions in postpartum hemorrhage can be more difficult. There can be slippage or overlapping of the suture while using a B-Lynch suture. Because the uterine shape is not completely distorted, patients with septate uterus can be candidates for a B-Lynch suture. There is no such reported case from the literature regarding efficacy of BLynch suture in mullerian anomalies. his case illustrates the potential benefits of B-Lynch compression suture in an uterus with mullerian anomalies.(J Turkish-German Gynecol Assoc 2011; 12: 47-9) Uterin konjenital anomalileri jinekolojik ve obstetrik sorunlara yol aça-bilir ve infertilite ile bulgu verebilir. Postpartum kanama (PPK) ve erken doğum gibi obstetrik komplikasyonlar uterin anomalili olgularda daha sık karşımıza çıkar. Özellikle fertilite arzusu olan olgularda uterin kompresyon sütürleri postpartum kanamanın kontrolünde faydalı olabilir. Uterin anomalide uterusun şeklinin değişmiş olması etkin sütür konulmasını zorlaştırabilir. Bu çalışmada derin uterin septumu olan bir olguda B-Lynch sütürü ile PPK'nın etkin şekilde kontrolü değerlen-dirilmiştir. 24 yaşında G3P0A2 hasta 31 haftalık gebe iken hastanemize vajinal kanama şikayeti ile başvurdu. Hasta plasenta dekolmanı tanı-sıyla acil sezeryana alındı sezeryan sonrası PPK gelişti. İntraoperatif olarak derin uterin septum izlendi. Fundus masajı ve uterotonik ajanlara başvuruldu ancak yanıt alınamadı. B-Lynch sütürü konulduktan sonra kanama kontrol altına alındı. Uterusun şeklinin değişmiş olması nedeniyle kanamayı durdurmak amacıyla kullanılan ikinci basamak yöntemler zorlaşır. Uterusun şeklinin tamamen değişmemiş olduğu septat uterusta B-Lynch sütürü faydalı olabilir. Litaratürde uterin anomalili olgularda B-Lynch sütürünün etkinliğinin değerlendirildiği başka bir olgu sunumu bulunmamaltadır bu olgu sunumu ile ute...

show abstract

Section: Discussionmentioning

confidence: 98%

B-Lynch suture technique to control postpartum hemorrhage in a patient with mullerian anomaly

Boyar¹,

Boynukalın²,

Boyar³

et al. 2011

J Turkish German Gynecol Assoc

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show abstract

“…However, success as defined by preservation of the uterus and fertility is more difficult to establish. There have been only isolated reports of successful subsequent pregnancies (8)(9)(10). Seven uneventful pregnancies after uterine compression sutures were reported in the largest review (30).…”

Section: Discussionmentioning

confidence: 99%

“…Subsequent clinical studies have shown that the response to the B-Lynch suture technique is complete and recovery uneventful (5-7). There is little information regarding any potential for compromised future fertility, although there have been several reports of successful pregnancy after the use of the B-Lynch compression suture (8)(9)(10)(11).…”

mentioning

confidence: 99%

Development of Asherman syndrome after conservative surgical management of intractable postpartum hemorrhage

Goojha

Case

Pierson

2010

Fertility and Sterility

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Objective-Describe a case of secondary infertility due to the development of severe Asherman Syndrome after the B-Lynch compression suture and uterine artery ligation, and to review the BLynch technique and documented complications. Design-Case report.Setting-Tertiary care hospital. Patient(s)-A 29-year-old primigravida patient. Intervention(s)-B-Lynch suture and uterine artery ligation. Main Outcome Measure(s)-Development of Asherman syndrome.Result(s)-Development of secondary infertility due to Asherman syndrome after the B-Lynch suture. Conclusion(s)-The B-Lynch suture is a highly successful conservative surgical technique used to treat this condition. There is little information regarding any potential for compromised future fertility, although there have been several reports of successful pregnancy after the use of the BLynch compression suture. In this report, we present a case of Asherman syndrome with complete obliteration of the uterine cavity after the B-Lynch suture.

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“…Causes of PPH were uterine atony in 31 of 37 cases (84%) and placenta accreta in 6 of 37 cases (16%). Median length of hospital stay was 8 days (range, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. There was no maternal death.…”

mentioning

confidence: 99%

“…The fertility data after UCS techniques are very limited. All five women from B-Lynch's first study went on to have other pregnancies and deliveries (9), and other cases of pregnancies after the BLynch procedure for PPH are reported in the literature (10)(11)(12). Four of 23 women had successful pregnancies after Cho's hemostatic suturing technique (5).…”

mentioning

confidence: 99%

Synechia after uterine compression sutures

Rathat

Trinh

Mercier

et al. 2011

Fertility and Sterility

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Successful Term Pregnancy after B-Lynch Compression Suture in a Previous Pregnancy on Account of Massive Primary Postpartum Hemorrhage

Cited by 26 publications

References 14 publications

B-Lynch suture technique to control postpartum hemorrhage in a patient with mullerian anomaly

B-Lynch suture technique to control postpartum hemorrhage in a patient with mullerian anomaly

Development of Asherman syndrome after conservative surgical management of intractable postpartum hemorrhage

Synechia after uterine compression sutures

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