Severe Intrauterine Adhesions Following Modified B-Lynch Procedure: A Case Report

Abstract Background B-Lynch suture is a highly effective procedure for controlling uterine bleeding due to uterine atony. Recently, various modifications of the B-Lynch suture have been developed, but evidence of these procedures’ safety and efficacy is still not enough. Case presentation: We reported a 30 years old female patient who underwent cesarean section and modified B-Lynch procedure because of uterine atony and refractory postpartum hemorrhage one year ago. During the surgery, the classic B-Lynch suture was initially applied to the uterus, and then No. 1 absorbable suture tightly encircled the uterine body, passing through the avascular area of the broad ligament below the round ligament, and was knotted at the anterior of the uterus. The patient experienced a significant reduction in menstrual flow after the surgery. Due to the patient's desire to have children, she underwent hysteroscopy and laparoscopy, which revealed severe intrauterine adhesions in the upper portion of the uterus. The patient's fertility was severely compromised. Conclusions The safety and effectiveness of uterine compression suture techniques still require further investigation. Obstetricians should exercise caution when selecting uterine compression suture procedures for patients with refractory postpartum hemorrhage and avoid excessive sutures to protect the patient's fertility.