Fertility after B-Lynch suture and stepwise uterine devascularization.

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.