Fertility after B-Lynch suture and stepwise uterine devascularization

Abstract

To report the obstetric outcome in a patient who had previously undergone a stepwise uterine devascularization followed by a B-Lynch suture for severe postpartum hemorrhage (PPH). Case report. University hospital. A 29-year-old woman whose first pregnancy was complicated by severe PPH due to uterine atony. Stepwise uterine devascularization followed by a B-Lynch suture because of persistent PPH. Preservation of reproductive capacity. Two years later, the patient conceived spontaneously and delivered a healthy infant by caesarean section after an uneventful pregnancy. During the operation, the uterus showed no marks of the former B-Lynch suture. This is the first reported case of obstetric outcome after stepwise uterine devascularization and B-Lynch suture. Further case series with mid- and long-term follow-up are required to determine whether the B-Lynch suture has an impact on the patient's subsequent fertility and pregnancies and to establish its place in the PPH surgical management algorithm.