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How B-Lynch suture and bilateral internal iliac artery ligation saved the uterus of a young patient with severe postpartum haemorrhage
  1. San San Win1,
  2. Helen Benedict Lasimbang1,
  3. Sai Nay Lynn AUng2 and
  4. Tat Boon Yeap3
  1. 1Reproductive Health Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
  2. 2Reproductive Health Department, Mahidol University Institute for Population and Social Research, Nakorn Pathom, Thailand
  3. 3Department of Anaesthesiology & Intensive Care, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
  1. Correspondence to Dr Tat Boon Yeap; boontat{at}ums.edu.my

Abstract

Obstetric haemorrhage is the leading cause of maternal death worldwide (27.1%) and more than 66% of its deaths were classified as postpartum haemorrhage (PPH). The most common cause of PPH is uterine atony. Obstetrician should be skillful in managing obstetric emergencies; especially pertaining to PPH. Application of the B-Lynch suture on an atonic uterus is one of the surgical options in PPH patients who wish to conserve the uterus and it has a very high success rate.

We present a primigravida patient who developed massive primary PPH followed by disseminated intravascular coagulation, which was successfully managed with B-Lynch suture and bilateral internal iliac artery ligation. We described in detail regarding the management of massive PPH and application of these surgical procedures on the atonic uterus with an attempt to preserve the uterus and future fertility in this young patient.

  • anaesthesia
  • pregnancy

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Footnotes

  • Twitter @San San Win @SanSanW44536770

  • Contributors SSW was the clinician in charge of this patient. HBL, SNLA and TBY are coauthors for this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.