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B-林奇缝合术:子宫保留技术还是子宫变形技术?附文献复习的病例报告

B-lynch: a technique for uterine conservation or deformation? A case report with literature review.

作者信息

Begum Jasmina, Pallave P, Ghose Seetesh

机构信息

Assistant Professor, Department of Obstetrics and Gynaecology, Mahatama Gandhi Medical College and Research Institute , Puducherry, India .

Associate Professor, Department of Obstetrics and Gynaecology, Mahatama Gandhi Medical College and Research Institute , Puducherry, India .

出版信息

J Clin Diagn Res. 2014 Apr;8(4):OD01-3. doi: 10.7860/JCDR/2014/8139.4284. Epub 2014 Apr 15.

Abstract

Postpartum haemorrhage is a leading cause of global maternal mortality and morbidity, accounting for 25-30% of all maternal deaths, and 75-90% of these casualties result from uterine atony. Uterine compressive sutures are a well established measure for control of haemorrhage following atonic postpartum haemorrhage, when medical and nonmedical interventions fail. Here, we are reporting a case of secondary infertility in a 24-year-old lady who had undergone an elective caesarean section for central placenta previa in her first pregnancy. She had massive postpartum haemorrhage, for which B-Lynch suture and vessel ligation were done. Subsequently, she failed to conceive for 4 years. This was because of severe pelvic adhesions and uterine deformation which were found intraoperatively, as a consequence of previous use of B-Lynch suture. As no definitive treatment could be offered to her, we suggested her to go for adoption.

摘要

产后出血是全球孕产妇死亡和发病的主要原因,占所有孕产妇死亡的25%-30%,其中75%-90%的死亡是由子宫收缩乏力导致的。当药物和非药物干预措施无效时,子宫压迫缝合术是控制宫缩乏力性产后出血的一项成熟措施。在此,我们报告一例24岁女性继发性不孕的病例,该女性在首次怀孕时因中央性前置胎盘接受了择期剖宫产。她产后发生了大出血,为此进行了B-Lynch缝合术和血管结扎术。随后,她4年未能怀孕。这是因为术中发现由于之前使用B-Lynch缝合术导致了严重的盆腔粘连和子宫变形。由于无法为她提供确切的治疗方法,我们建议她考虑收养。

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Synechia after uterine compression sutures.子宫压迫缝合术后宫腔粘连。
Fertil Steril. 2011 Jan;95(1):405-9. doi: 10.1016/j.fertnstert.2010.08.055.
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Fertility after B-Lynch suture and stepwise uterine devascularization.
Fertil Steril. 2009 Mar;91(3):934.e5-9. doi: 10.1016/j.fertnstert.2008.09.082. Epub 2008 Nov 8.
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Uterine necrosis following B-Lynch suture for primary postpartum haemorrhage.
BJOG. 2006 Apr;113(4):486-8. doi: 10.1111/j.1471-0528.2006.00890.x.

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