A case report on decidual cast following B-lynch compression suture


  • Laleeta Meena Department of Obstetrics and Gynecology, Sardar Patel Medical College, Bikaner, Rajasthan, India
  • Suman Budania Department of Obstetrics and Gynecology, Sardar Patel Medical College, Bikaner, Rajasthan, India




Decidual cast, PPH, B-lynch compression suture


In case of atonic postpartum haemorrhage (PPH) and traumatic PPH or cervical tear extended deep up to lower uterine segment exploratory laparotomy is the last resort to control PPH. It was a case of 20 years old female admitted in labour room with chief complain of bleeding per vaginum and something coming out of vagina after 6 weeks of post laprotomy for atonic postpartum hemorrhage. Compression sutures were applied and bilateral uterine artery ligation was done at time of laparotomy. After 6 weeks post laparotomy the patient was presented with complain of something coming out from vagina. An examination was performed under short general anesthesia in the operation theater, the mass was removed without any resistance. A provision diagnosis of decidual cast was made which was later confirmed by histopathological report which shows autolytic changes in decidual tissue. Women which are undergoing bilateral uterine artery ligation or compression suture for management of postpartum hemorrhage, should be informed about potential complication. Postoperative follow-up is necessary for any complications.

Author Biography

Laleeta Meena, Department of Obstetrics and Gynecology, Sardar Patel Medical College, Bikaner, Rajasthan, India

Obg 2nd year Resident 



Combs CA, Murphy EL, Laros RK. Factors associated with postpartum haemorrhage with vaginal birth. Obstet Gynecol. 1991;77:69.

Omar, Smith. Membranous Dysmenorrhea. Sci World J. 2007;7:1900-3.

Greenblatt RB, Hammond MD, Clark SL. Membranous dysmenorrhea: Studies in aetiology and treatment. Am J Obstet Gynecol. 1954;68:835-44.

B-Lynch C, Coker A, Lawal AH, Abu J, Cowen MJ. The B-Lynch surgical technique for the control of massive post- partum haemorrhage: An alternative to hysterectomy? Five cases reported. Br J Obstet Gynaecol. 1997;104:372.

Cho JH, Jun HS, Lee CN. Hemostatic suturing technique for uterine bleeding during caesarean delivery. Obstet Gynecol. 2000;96:129.

Hayman RG, Arul Kumaran S, Steer PJ. Uterine compression sutures: Surgical management of postpartum haemorrhage. Obstet Gynecol. 2002;99:502.

Zhenag J, Xiong X, Ma Q, Zhang X, Li M. A new uterine compression suture for postpartum haemorrhage with atony. BJOG. 2011;118:370.

Grotegut CA, Larsen FW, Jones MR, Livingston E. Erosion of a B-Lynch suture through the uterine wall: A case report. J Reprod Med. 2004;49:849.

Baskett TF. Uterine compression sutures for postpartum haemorrhage: Efficacy, morbidity, and subsequent pregnancy. Obstet Gynecol. 2007;110:68.

Joshi VM, Srivastava M. Partial ischemic necrosis of the uterus following a uterine brace compression suture. BJOG. 2004;111:279.

Akoury H, Sherman C. Uterine wall necrosis following combined B-Lynch and Cho square sutures for the treatment of primary PPH. J Obstet Gynecol Can. 2008;30:421.

Treloar EJ, Anderson RS, Andrews HS, Bailey JL. Uterine necrosis following B-Lynch suture for primary PPH. BJOG. 2006;113:486.






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