Later reproductive health after B-Lynch sutures: A follow-up study after 10 years' clinical use of the B-Lynch suture

摘要

Objective To evaluate the reproductive prognosis after having a B-Lynch suture placed previously. Design Follow-up study based on patients' records. Setting University hospital setting (level three; 4,800 deliveries per year). Patient(s) All patients registered to have had a B-Lynch suture placed from 2002 to 2012. Intervention(s) None. Main Outcome Measure(s) Future pregnancies. Result(s) Forty-four B-Lynch procedures were identified in 43 women. Twenty-six were primiparas at the time of B-Lynch suture. Follow-up took place a median 45 months (range, 17-126 months) after B-Lynch suture placement; one woman was lost to follow-up. Overall, 16 of 42 women obtained a new pregnancy. Among primiparas, 44% either had an ongoing pregnancy or a delivery. Among women not having a succeeding pregnancy, one woman had a peripartum hysterectomy, one was advised against pregnancy, one developed Asherman's syndrome, and three women were known to attempt to obtain pregnancy. In deliveries after a previous B-Lynch suture, 3 of 13 women had estimated bleeding above 1,000 mL, and 2 of these had severe bleeding. A time trend was observed indicating that B-Lynch sutures are placed increasingly often. Conclusion(s) The reproductive prognosis after a B-Lynch suture has been placed seems to be relatively good. Nonetheless, complications that might influence future pregnancy may occur, and advice given should address this.