title: Reproductive performance after conservative surgical treatment of postpartum hemorrhage.
abstract: OBJECTIVE
  To evaluate the impact of bilateral internal iliac artery ligation (BIL), bilateral uterine artery ligation (BUAL), step-wise uterine devascularization (SWUD), and B-Lynch on infertility, ovarian reserve, and pregnancy outcome.
  
  
  METHODS
  The study included 168 infertile or pregnant patients-recruited at outpatient clinics in Egypt-who had previously undergone uterine-sparing surgery (BIL [group I], n=59; SWUD [group II], n=65); BUAL [group III], n=2; and B-Lynch [group IV], n=42). One-way analysis of variance was used to compare the prevalence of infertility, the status of ovarian reserve, and the prevalence and type of relevant maternal and/or fetal obstetric complications between the groups.
  
  
  RESULTS
  Groups II and IV had the highest prevalences of infertility. The ovarian reserve was significantly lower in group II. Unexplained infertility was the predominant cause of infertility in group I, anovulation and premature ovarian failure in group II, and endometriosis and intrauterine adhesions in group IV. The frequency of obstetric complications, particularly placenta previa and preterm labor, was high in group IV.
  
  
  CONCLUSIONS
  Of the 4 procedures, BIL had the least deleterious effect on reproductive performance; SWUD increased the risk of premature ovarian failure, and B-Lynch increased the risks of endometriosis, intrauterine adhesions, placenta previa, and preterm labor.
authors.affiliation: Department of Obstetrics and Gynecology, Sohag University, Sohag, Egypt. Electronic address: salahrasheed67@yahoo.com.
authors.forename: Salah M
authors.initials: SM
authors.lastname: Rasheed
authors.affiliation: Department of Obstetrics and Gynecology, Sohag University, Sohag, Egypt.
authors.forename: Magdy M
authors.initials: MM
authors.lastname: Amin
authors.affiliation: Department of Obstetrics and Gynecology, Qena University, Qena, Egypt.
authors.forename: Ahmed H
authors.initials: AH
authors.lastname: Abd Ellah
authors.affiliation: Department of Obstetrics and Gynecology, Assiut University, Assiut, Egypt.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Abo Elhassan
authors.affiliation: Department of Obstetrics and Gynecology, Al Azhar University, Cairo, Egypt.
authors.forename: Mazen A
authors.initials: MA
authors.lastname: El Zahry
authors.affiliation: Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt.
authors.forename: Hala A
authors.initials: HA
authors.lastname: Wahab
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D007247:Infertility, Female / Q000453:epidemiology*; D008026:Ligation; D006473:Postpartum Hemorrhage / Q000601:surgery*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D015995:Prevalence; D055988:Uterine Artery / Q000601:surgery; D055815:Young Adult
keywords: Infertility; Pregnancy outcome; Uterine-sparing procedures