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Fertility after B-Lynch suture and stepwise uterine devascularization
Loïc Sentilhes1, Alexis Gromez, Caroline Trichot
1Department of Obstetrics and Gynecology, Rouen University Hospital, Charles Nicolle, Rouen, France. loicsentilhes@hotmail.com
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).
Design:
Case report.
Setting:
University hospital.
Patient(S):
A 29-year-old woman whose first pregnancy was complicated by severe PPH due to uterine atony.
Intervention(S):
Stepwise uterine devascularization followed by a B-Lynch suture because of persistent PPH.
Main Outcome Measure(S):
Preservation of reproductive capacity.
Result(S):
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.
Conclusion(S):
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.
