Bilateral uterine and ovarian artery ligation in addition to B-lynch suture may be an alternative to hysterectomy for uterine atonic hemorrhage.

Purpose Of Investigation: To evaluate the effectiveness of bilateral uterine arteries and ovarian artery ligation followed by B-Lynch compression suturing in controlling atonic postpartum hemorrhage.

Methods: In this retrospective study, the data of eight patients that had uterine atony during cesarean section and treated by bilateral uterine and ovarian artery ligation followed by B-Lynch compression suturing during the period from February 2009 to September 2010 were collected and analyzed.

Results: Eight cases were treated by the above protocol; the average age of the patients was 25.25 +/- 5.09 years, and the mean gestational age was 35.75 +/- 3.80 weeks. Seven of the patients were primiparous. They were hospitalized on average 5.25 +/- 2.31 days. The mean operation time was 61.25 +/- 24.60 minutes and mean estimated blood loss was 2787.5 +/- 1573.38 ml. Internal iliac artery ligation was necessary in one patient only. Hysterectomy was not performed in any of the patients. Five patients had intraoperative or postoperative blood transfusion.

Conclusion: The addition of uterine artery and ovarian artery ligation to the B-Lynch suture may be considered as a major hemostatic step before proceeding to hysterectomy in cases of uterine atony bleeding, and all gynecologic surgeons should be familiar with it.