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A B-Lynch suture is a suturing technique to brace and stabilize the uterus in cases of severe postpartum hemorrhage. This procedure is named for the surgeon who invented it, Christopher B. Lynch. One advantage of this technique is that it conserves fertility so that the patient can have more children in the future.
Postpartum hemorrhage is a potentially serious complication of labor and delivery in which the uterus fails to clamp down after delivery, and blood flows freely. Techniques to address it can include medications to facilitate uterine cramping, manual compression of the uterus to stop the bleeding and surgical options. In extreme cases, it might be necessary to remove the uterus to stop the bleeding. This can be very traumatic for the patient. New techniques to address hemorrhage while retaining fertility are a constant topic of research.
In the B-Lynch suture, the practitioner starts with manual compression of the uterus to determine whether the procedure would be effective. The compression should slow or stop the bleeding and might improve uterine tone, encouraging the muscle tissue to start contracting. Next, the care provider can place a series of long sutures to maintain compression. The sutures are very tight to keep the uterus compressed even after the care provider stops directly applying pressure.
Surgeons work with absorbable suture materials when they place a B-Lynch suture. As the uterus recovers, enzymes in the body will eat away at the sutures and dissolve them so that they do not remain in the uterus and pelvic cavity. The patient will need time to recover before attempting another pregnancy, but it should be possible for her to get pregnant again and successfully carry the baby to term.
A patient who has a history of a B-Lynch suture procedure should discuss this with her obstetrician at the early stages of pregnancy or family planning. The doctor might have some concerns about the pregnancy and could recommend some extra monitoring or steps to make pregnancy, labor and delivery as safe as possible. Patients who experience fertility problems after a B-Lynch suture might want a thorough evaluation to determine whether the procedure caused the infertility or whether it is a separate issue; fertility can be complex, and many changes to a patient's body and endocrine system could play a role in the development of infertility.
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