Asymptomatic Uterine Rupture in a Pregnancy Following B-Lynch Suture Application in a Previous Delivery: A Case Report

The B-Lynch suture, designed to control severe postpartum hemorrhage by compressing the uterus, is effective in reducing maternal mortality rates. However, it can lead to complications such as infection and uterine necrosis. This report presents a rare case of asymptomatic uterine rupture in a subsequent pregnancy following a B-Lynch suture. A woman in her mid-30s, gravida 3, para 2, presented at 32 weeks gestation in labor and underwent a repeat caesarean section. During delivery and visualization of the uterus, a 3-cm uterine rent was incidentally discovered near the site of the previous B-Lynch suture at the posterior aspect of the uterus. On review of prior medical reports provided by the patient, it was noted that the B-Lynch procedure was previously performed using Polydioxanone sutures rather than traditional absorbable sutures and was deemed a potential contributor to this presentation. This case emphasizes the importance of appropriate suture materials and techniques when performing a B-Lynch suture and presents a less commonly known potential long-term effect and complication. Further, obstetricians should be wary in subsequent pregnancies of the potential for uterine rents and aim to carefully visualize the previous suture site intraoperatively, regardless of symptomatology.