A patient who underwent B-Lynch suture for PPH 6 months ago now presents with secondary amenorrhoea. HSG shows intrauterine adhesions. This complication is MOST directly attributable to:
- A Persistent endometritis post-PPH
- B Sheehan syndrome from pituitary ischaemia
- C Asherman syndrome secondary to uterine ischaemia from compression suture ✓
- D Cervical stenosis from ergometrine use
Correct answer: C. Asherman syndrome secondary to uterine ischaemia from compression suture
Explanation
B-Lynch and other uterine compression sutures can cause focal myometrial ischaemia and necrosis, resulting in Asherman syndrome (intrauterine adhesions). Case series report secondary amenorrhoea and adhesions after compression sutures, particularly when combined with uterine cavity evacuation. Sheehan syndrome causes pituitary failure without intrauterine adhesions and would not show adhesions on HSG.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.