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
Placement of a B-Lynch suture is not associated with an increased risk of future adverse pregnancy outcomes related to abnormal placentation.
Department of Maternal-Fetal Medicine, Northwestern University, Chicago, Illinois.
Corresponding author: Alison D. Cowan, MD, MS, Northwestern University, Department of Maternal-Fetal Medicine, 250 E Superior, Suite 5-2177, Chicago, IL 60611, e-mail: firstname.lastname@example.org.
The authors thank Joseph Pincus for his assistance in identification of eligible participants in the study.
Presented as a poster at the Society for Maternal Fetal-Medicine 34th Annual Meeting, February 3–8, 2014, New Orleans, Louisiana.
Financial Disclosure The authors did not report any potential conflicts of interest.