{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:40:29Z","timestamp":1756377629425,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,7,29]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>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.<\/jats:p>\n               <jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2021-244226","type":"journal-article","created":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T12:06:39Z","timestamp":1628769999000},"page":"e244226","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["How B-Lynch suture and bilateral internal iliac artery ligation saved the uterus of a young patient with severe postpartum haemorrhage"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7396-2206","authenticated-orcid":false,"given":"San San","family":"Win","sequence":"first","affiliation":[{"name":"Reproductive Health Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen Benedict","family":"Lasimbang","sequence":"additional","affiliation":[{"name":"Reproductive Health Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sai Nay","family":"Lynn AUng","sequence":"additional","affiliation":[{"name":"Reproductive Health Department, Mahidol University Institute for Population and Social Research, Nakorn Pathom, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2517-597X","authenticated-orcid":false,"given":"Tat Boon","family":"Yeap","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology & Intensive Care, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"key":"2025082803065185000_14.8.e244226.1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-9-1"},{"key":"2025082803065185000_14.8.e244226.2","first-page":"247","article-title":"A national update on rates of postpartum haemorrhage and related interventions","volume":"18","author":"Ahmadzia","year":"2020","journal-title":"Blood Transfus"},{"key":"2025082803065185000_14.8.e244226.3","doi-asserted-by":"crossref","DOI":"10.4081\/jphr.2020.1842","article-title":"Maternal complications and risk factors for mortality","volume":"9","author":"Diana","year":"2020","journal-title":"J Public Health Res"},{"key":"2025082803065185000_14.8.e244226.4","unstructured":"Jeganathan R , ed. Preliminary Report of National Obstetrics Registry. Kuala Lumpur, Malaysia: National Obstetrics Registry, 2013-2015."},{"key":"2025082803065185000_14.8.e244226.5","doi-asserted-by":"crossref","unstructured":"Thompson P . Postpartum Haemorrhage\", Obstetrics and Gynaecology: An evidence-based text for MRCOG 2016:506\u201311.","DOI":"10.1201\/b19647-64"},{"key":"2025082803065185000_14.8.e244226.6","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1016\/S2214-109X(17)30428-X","article-title":"Updated who recommendation on intravenous tranexamic acid for the treatment of post-partum haemorrhage","volume":"6","author":"Vogel","year":"2018","journal-title":"Lancet Glob Health"},{"key":"2025082803065185000_14.8.e244226.7","unstructured":"Likis FE , Sathe NA , Morgans AK . Management of postpartum hemorrhage. Comparative effectiveness review No. 151. (prepared by the Vanderbilt evidence-based practice center under contract No. 290-2012-00009-I.) AHRQ publication No. 15-EHC013-EF. Rockville, MD: Agency for Healthcare Research and Quality, 2015 April. www.effectivehealthcare.ahrq.gov\/reports\/final.cfm"},{"key":"2025082803065185000_14.8.e244226.8","unstructured":"Mavrides E , Allard S , Chandraharan E . On behalf of the Royal College of obstetricians and gynaecologists. prevention and management of postpartum haemorrhage. BJORG 2016;124."},{"key":"2025082803065185000_14.8.e244226.9","doi-asserted-by":"crossref","first-page":"293.e1","DOI":"10.1016\/j.ajog.2019.11.1287","article-title":"Uterine balloon tamponade for the treatment of postpartum hemorrhage: a systematic review and meta-analysis","volume":"222","author":"Suarez","year":"2020","journal-title":"Am J Obstet Gynecol"},{"key":"2025082803065185000_14.8.e244226.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-015-1054-y"},{"key":"2025082803065185000_14.8.e244226.11","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000008443","article-title":"Emergency obstetric hysterectomy for life-threatening postpartum hemorrhage","volume":"96","author":"Zhang","year":"2017","journal-title":"Medicine"},{"key":"2025082803065185000_14.8.e244226.12","first-page":"OD01","article-title":"GhOSe S. B-lynch: a technique for uterine conservation or deformation? 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