Uterine necrosis after B-Lynch suture in a classical caesarean section

摘要

I read with interest the article by Mowat et al, 'A necrotic uterus after a B-Lynch suture: fertility sparing surgery'. Classical caesarean section (CS) was performed due to placenta praevia and clinical chorioamnionitis. The authors suggested that chorioamnionitis may have been a predisposing factor for uterine necrosis. I have three comments.First, B-Lynch suture with classical CS incision, and not lower uterine segment transverse incision, may be technically difficult. Even if it can be performed, it may not achieve sufficient haemostasis of the lower uterine segment. Mowat et al. employed a classical CS, a vertical incision into the body of the uterus above the lower uterine segment, according to Williams Textbook.2 Mowat et al. stated, 'the technique used was that described by B-Lynch in his original paper except the uterus was not reopened to place the suture'. This can be read as B-Lynch suture was performed with a classical CS incision.