EC Gynaecology

B-lynch compression sutures, applied as a life-saving procedure in cases of atonic postpartum hemorrhage can sometimes lead to life-threatening complications. We report a case of uterine necrosis following B-lynch compression sutures application, at the time of cesarean section. The end result was a hysterectomy.

A 34-year-old gravida 2, para 1, was admitted in labor at 40 weeks and 2 days. She was submitted to a cesarean section due to obstructed labor. Because of significant refractory atony, B-Lynch hemostatic sutures were placed. On postoperative day 8, the patient returned to the hospital due to persistent pain, abdominal distension, fetid-smelling lochia, vomiting and cessation of gas and feces emission. CT scan revealed intrauterine air content and marked distention of the intestinal loops. Due to suspected intra-abdominal infectious focus, she underwent exploratory laparotomy, which revealed uterine necrosis. A total hysterectomy was performed.

Although compression sutures are an effective technique for patients with uterine atony, uterine necrosis is a rare complication. It is important to promptly recognize signs and symptoms of this possible complication in order to act effectively.

 Keywords: Postpartum Hemorrhage; Uterine Necrosis; B-Lynch Sutures

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