Fertility after B-Lynch suture and stepwise uterine devascularization.
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.
Sentilhes
Loïc
L
Department of Obstetrics and Gynecology, Rouen University Hospital, Charles Nicolle, Rouen, France. loicsentilhes@hotmail.com
Gromez
Alexis
A
Trichot
Caroline
C
Ricbourg-Schneider
Aude
A
Descamps
Philippe
P
Marpeau
Loïc
L
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*