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  • Title: Fertility after B-Lynch suture and stepwise uterine devascularization.
    Author: Sentilhes L, Gromez A, Trichot C, Ricbourg-Schneider A, Descamps P, Marpeau L.
    Journal: Fertil Steril; 2009 Mar; 91(3):934.e5-9. PubMed ID: 18996514.
    Abstract:
    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.
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