Bilateral uterine and ovarian artery ligation in addition to B-lynch suture may be an alternative to hysterectomy for uterine atonic hemorrhage.
OBJECTIVE
To evaluate the effectiveness of bilateral uterine arteries and ovarian artery ligation followed by B-Lynch compression suturing in controlling atonic postpartum hemorrhage.


METHODS
In this retrospective study, the data of eight patients that had uterine atony during cesarean section and treated by bilateral uterine and ovarian artery ligation followed by B-Lynch compression suturing during the period from February 2009 to September 2010 were collected and analyzed.


RESULTS
Eight cases were treated by the above protocol; the average age of the patients was 25.25 +/- 5.09 years, and the mean gestational age was 35.75 +/- 3.80 weeks. Seven of the patients were primiparous. They were hospitalized on average 5.25 +/- 2.31 days. The mean operation time was 61.25 +/- 24.60 minutes and mean estimated blood loss was 2787.5 +/- 1573.38 ml. Internal iliac artery ligation was necessary in one patient only. Hysterectomy was not performed in any of the patients. Five patients had intraoperative or postoperative blood transfusion.


CONCLUSIONS
The addition of uterine artery and ovarian artery ligation to the B-Lynch suture may be considered as a major hemostatic step before proceeding to hysterectomy in cases of uterine atony bleeding, and all gynecologic surgeons should be familiar with it.
Department of Obstetrics and Gynecology, Selcuk University Meram Medical School, Konya, Turkey. kazimgezginc@hotmail.com
K
K
Gezginç
F
F
Yazici
T
T
Koyuncu
A S
AS
Mahmoud
D000328:Adult; D001158:Arteries; D016063:Blood Loss, Surgical; D005260:Female; D006488:Hemostasis, Surgical; D006801:Humans; D007044:Hysterectomy; D008026:Ligation; D010053:Ovary / Q000098:blood supply*; D006473:Postpartum Hemorrhage / Q000503:physiopathology / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D013537:Sutures; D055988:Uterine Artery / Q000601:surgery*; D014593:Uterine Inertia / Q000503:physiopathology; D055815:Young Adult