From Hemorrhage to Pyometra: A Complex Postpartum Cascade Following B-Lynch Suturing and Bilateral Internal Iliac Artery Ligation.

Postpartum hemorrhage (PPH) due to uterine atony remains a major cause of maternal morbidity and mortality worldwide. When medical therapy fails, conservative surgical measures, such as uterine compression sutures and vascular ligation, are used to control bleeding while preserving fertility. Although generally effective, these procedures may rarely lead to severe complications, including uterine ischemia, infection, and necrosis. We report a case of a primiparous woman who developed primary PPH following normal vaginal delivery and required uterine compression sutures for hemostasis. Subsequently, she developed complete uterine necrosis necessitating hysterectomy.