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Review
. 2010 Aug;94(3):1098.e1-5.
doi: 10.1016/j.fertnstert.2010.01.078. Epub 2010 Mar 26.

Development of Asherman syndrome after conservative surgical management of intractable postpartum hemorrhage

Ciaran A Goojha  1 , Allison Case, Roger Pierson
Affiliations
Review

Development of Asherman syndrome after conservative surgical management of intractable postpartum hemorrhage

Ciaran A Goojha et al. Fertil Steril. 2010 Aug.

Abstract

Objective: Describe a case of secondary infertility due to the development of severe Asherman Syndrome after the B-Lynch compression suture and uterine artery ligation, and to review the B-Lynch technique and documented complications.

Design: Case report.

Setting: Tertiary care hospital.

Patient(s): A 29-year-old primigravida patient.

Intervention(s): B-Lynch suture and uterine artery ligation.

Main outcome measure(s): Development of Asherman syndrome.

Result(s): Development of secondary infertility due to Asherman syndrome after the B-Lynch suture.

Conclusion(s): The B-Lynch suture is a highly successful conservative surgical technique used to treat this condition. There is little information regarding any potential for compromised future fertility, although there have been several reports of successful pregnancy after the use of the B-Lynch compression suture. In this report, we present a case of Asherman syndrome with complete obliteration of the uterine cavity after the B-Lynch suture.

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Figures

FIGURE 1
FIGURE 1
Illustration of B-Lynch suture. Reproduced with permission from B-Lynch et al. Br J Obstet Gynaecol 1997;104:372–5
FIGURE 2
FIGURE 2
Ultrasound image of the uterus in saggital plane. The cervix is to the right of the image and the fundus is seen to the left. Collagen reaction from B-Lynch suture visible within myometrium (arrow).
FIGURE 3
FIGURE 3
Uterine artery located with Doppler and measured ultrasound. Uterine artery diameter <50% of normal value bilaterally.
FIGURE 4
FIGURE 4
Doppler ultrasound examination of endometrial cavity. Minimal perfusion to endometrium.
See this image and copyright information in PMC

Comment in

  • Has B-Lynch suture hidden long-term effects?
    Sentilhes L, Descamps P, Marpeau L. Sentilhes L, et al. Fertil Steril. 2010 Sep;94(4):e62. doi: 10.1016/j.fertnstert.2010.06.021. Epub 2010 Jul 15. Fertil Steril. 2010. PMID: 20633876 No abstract available.

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