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

Abstract

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.