B-lynch suture, uterine arterial ligation and foley catheter application as fertility sparing treatment in postpartum atony

Abstract

Postpartum hemorrhage (PPH) is one of the leading cause of maternal mortality. The majority of deaths due to postpartum hemorrhage are most commonly caused by atonia. We aimed to describe here a patient with early postpartum hemorrhage treated with the combination of B-Lynch suture, bilateral uterine artery ligation and foley catheter. The 27-year-old nullipara patient was at 38 weeks of gestation was performed an emergency cesarean section for fetal distress. Atony developed after the emergence of the placenta. After medical treatment, bleeding persisted from the lower segment of the uterus. Bilateral uterovarian artery ligation, B-Lynch suture were performed and foley catheter was placed in the lower uterine segment. The postoperative course was uneventful. In atony cases where medical therapy failed, uterovarian artery ligation and B Lynch suture is a successful combination. Also, foley catheter application should be kept in mind as an additional method with bleeding from the lower uterine segment.