Grotegut Chad A, Larsen Frederick W, Jones Michael R, Livingston Elizabeth
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA.
J Reprod Med. 2004 Oct;49(10):849-52.
The B-Lynch uterine suture brace has been used for the surgical treatment of postpartum hemorrhage. To date, no complications of this procedure have been reported. We describe B-Lynch suture erosion through the uterine wall identified at a 6-week postpartum visit.
A 19-year-old primigravida underwent a primary low transverse cesarean section at term for arrest of descent. The surgery was complicated by postpartum hemorrhage secondary to uterine atony unresponsive to medical management. The patient underwent successful placement of a B-Lynch suture using delayed, absorbable suture for control of the hemorrhage and had an uneventful postoperative course. At her 6-week postpartum examination, she was found to have the suture protruding from the uterine cervical os. The suture was removed in its entirety without difficulty. Follow-up sonohysterography at 6 months identified a small defect in the anterior wall of the lower uterine segment, corresponding to the probable site of suture erosion.
Erosion of suture through the uterine wall can be a complication of the B-Lynch uterine suture brace. Delayed, absorbable suture is less desirable than absorbable suture for this procedure due to the risk of erosion through the uterine wall.
B-Lynch子宫缝合术已用于产后出血的外科治疗。迄今为止，尚未有该手术并发症的报道。我们描述了产后6周检查时发现的B-Lynch缝线穿透子宫壁的情况。
一名19岁初产妇足月时因产程停滞行初次低位横切口剖宫产术。手术因子宫收缩乏力导致产后出血而复杂化，药物治疗无效。患者成功放置B-Lynch缝线，使用延迟吸收缝线控制出血，术后恢复顺利。在产后6周检查时，发现缝线从子宫颈口突出。缝线被完整顺利取出。6个月后的超声子宫造影显示子宫下段前壁有一个小缺损，对应于缝线可能侵蚀的部位。
缝线穿透子宫壁可能是B-Lynch子宫缝合术的一种并发症。由于存在穿透子宫壁的风险，对于该手术，延迟吸收缝线不如可吸收缝线理想。
