B-Lynch suture in the treatment of postpartum hemorrhage due to uterine atony and impact on long-term fertility / 中华围产医学杂志

ABSTRACT

Objective To evaluate the effects of B-Lynch suture for postpartum hemorrhage due to uterine atony,and to clarify its influence on long-term fertility and next pregnancy outcome.Methods We retrospectively collected the medical records of 150 women who underwent B-Lynch suture during cesarean section due to intra-operative bleeding caused by uterine atony from January 1,2006 to December 31,2013 in Peking University First Hospital.Follow-up was carried out to assess postoperative menstruation and subsequent pregnancy outcomes.Results All the cases underwent B-Lynch suture which successfully retained the uterus.Satisfactory hemostasis was achieved in 131 women (87.3％) who underwent B-Lynch suture only,and in eighteen women (12.0％) who had bilateral uterine artery ascending branch ligation at the same time;and in one patient (0.7％) who underwent B-Lynch suture and uterine artery embolization four hours later due to poor uterine contraction.Of the 141 (94.0％) cases followed up after surgery,menstrual cycle was assessed in a total of 104 women:no changes in the menstrual cycle and bleeding volume were noted in 67 cases (64.4％),prolonged menstruation was observed in five cases (4.8％),menorrhagia in ten cases (9.6％),and hypomenorrhea in 22 cases (21.2％).Eleven women (23.9％) became pregnant and delivered in two to four years after the surgery,and all were full-term abdominal delivery.Conclusions B-Lynch suture is a simple,safe,and effective treatment for postpartum hemorrhage due to uterine atony,without significant change of menstruation.B-Lynch suture is not associated with infertility,and the postoperative pregnant outcome is good.