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Obstetrics & Gynecology:
doi: 10.1097/AOG.0000000000000418
Contents: Original Research

Subsequent Pregnancy Outcome After B-Lynch Suture Placement

Cowan, Alison D. MD, MS; Miller, Emily S. MD, MPH; Grobman, William A. MD, MBA

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Abstract

OBJECTIVE: To evaluate whether use of the B-Lynch suture is associated with subsequent adverse pregnancy outcomes.

METHODS: This is a cohort study of women who experienced postpartum hemorrhage between January 2000 and June 2010 and had a subsequent pregnancy at a single university hospital. Women who had postpartum hemorrhage and B-Lynch suture were compared with those complicated by postpartum hemorrhage but no B-Lynch suture placement. The primary outcome was a composite adverse outcome related to placentation abnormalities and included placenta previa, placenta accreta, preeclampsia, preterm birth, or a small-for-gestational-age neonate. The study was powered to detect a twofold difference in the frequency of the composite outcome.

RESULTS: Two hundred fifty-two patients met inclusion criteria, 63 of whom had a prior B-Lynch suture. Women with a prior B-Lynch had a higher mean estimated blood loss (1,800 mL compared with 1,200 mL, P<.001) and were more likely to have received a blood transfusion (29.2% compared with 13.3%, P=.01) in the index pregnancy. The composite outcome was not different between the groups (14.3% compared with 13.8%, P=.92). A logistic regression controlling for potential confounding factors did not show any association between exposure to a B-Lynch suture and adverse pregnancy outcome in a subsequent pregnancy (adjusted odds ratio 0.88, 95% confidence interval 0.34–2.28.

CONCLUSION: Placement of a B-Lynch suture is not associated with an increased risk of future adverse pregnancy outcomes related to abnormal placentation.

LEVEL OF EVIDENCE: II

© 2014 by The American College of Obstetricians and Gynecologists.

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