Post-Partum Haemorrhage

Fertil Steril. 2005 Aug;84(2):509.
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Fertility after B-Lynch suture and hypogastric artery ligation.
Api M, Api O, Yayla M.

Department of Obstetrics and Gynecology, Haseki Education and Research Hospital, Istanbul, Turkey. muratapi@hotmail.com

Objectives:

To report a case of successful pregnancy after hypogastric artery ligation and the B-Lynch brace suturing technique.

Design:

Case report.

Setting:

Education and research hospital. PATIENT(S): A 22-year-old woman, whose first pregnancy was terminated by cesarean section owing to abruptio placenta and intrauterine fetal demise diagnosed at the 26th week of gestation, referred to our clinic for uterine atony. INTERVENTION(S): Hypogastric artery ligation and the B-Lynch brace suturing technique. MAIN OUTCOME MEASURE(S): Clinical pregnancy and live birth. RESULT(S): Two years after the surgery, the patient conceived spontaneously and delivered a healthy infant after an uneventful pregnancy. CONCLUSION(S): This is the first reported case of successful pregnancy after hypogastric artery ligation and B-Lynch suturing technique. This life-saving therapeutic option for severe postpartum hemorrhage appears to be a safe procedure that does not impair subsequent fertility and pregnancy outcomes. The B-Lynch suturing technique seems to be simple and has the capability of preserving the uterus; therefore it may be considered as the first-line surgical treatment for uterine atony before considering hysterectomy.