title: Fertility after B-Lynch suture and stepwise uterine devascularization.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  Case report.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A 29-year-old woman whose first pregnancy was complicated by severe PPH due to uterine atony.
  
  
  METHODS
  Stepwise uterine devascularization followed by a B-Lynch suture because of persistent PPH.
  
  
  METHODS
  Preservation of reproductive capacity.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Rouen University Hospital, Charles Nicolle, Rouen, France. loicsentilhes@hotmail.com
authors.forename: Loïc
authors.initials: L
authors.lastname: Sentilhes
authors.forename: Alexis
authors.initials: A
authors.lastname: Gromez
authors.forename: Caroline
authors.initials: C
authors.lastname: Trichot
authors.forename: Aude
authors.initials: A
authors.lastname: Ricbourg-Schneider
authors.forename: Philippe
authors.initials: P
authors.lastname: Descamps
authors.forename: Loïc
authors.initials: L
authors.lastname: Marpeau
mesh_terms: D000328:Adult; D001158:Arteries / Q000601:surgery; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D005298:Fertility; D006489:Hemostatic Techniques / Q000009:adverse effects; D006801:Humans; D008026:Ligation; D050498:Live Birth; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000601:surgery*; D011247:Pregnancy; D012720:Severity of Illness Index; D013536:Suture Techniques / Q000009:adverse effects; D014599:Uterus / Q000098:blood supply*