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Bilateral uterine artery ligation plus B-Lynch procedure for atonic postpartum hemorrhage with placenta accreta.

Authors:
Ahmed Y Shahin Tarek A Farghaly Safwat A Mohamed Mahmoud Shokry Diaa-Eldeen M Abd-El-Aal Mohammed A Youssef

Int J Gynaecol Obstet 2010 Mar 27;108(3):187-90. Epub 2009 Nov 27.

Department of Obstetrics and Gynecology, Women's Health Centre, Assiut University, Egypt.

Objective: To assess the effectiveness of bilateral uterine artery ligation followed by B-Lynch compression suturing in women with atonic postpartum hemorrhage and placental site bleeding due to adherent placenta accreta.

Method: This protocol was followed in 26 women undergoing cesarean delivery for placenta accreta.

Results: Two women died from disseminated intravascular coagulopathy. In the remaining 24 women, placental remnants completely disappeared within 8 months and ovulation resumed after a mean+/-SD of 51.6+/-3.2 days. Moreover, 18 women (75%) became pregnant within 12 months.

Conclusion: Atonic postpartum hemorrhage and placental site bleeding due to adherent placenta accreta can be safely controlled by bilateral uterine artery ligation followed by B-Lynch compression suturing in women who desire to remain fertile.

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http://dx.doi.org/10.1016/j.ijgo.2009.08.035DOI Listing
March 2010

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