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The B-Lynch brace suture technique is a life-saving procedure. It is a simple and safe alternative to hysterectomy. Thus, it preserves fertility with less surgical morbidity. In this case series, we evaluated the use of a novel modification of the B-Lynch brace suture to minimise its potential reported complications. Five women with intractable primary atonic postpartum haemorrhage were reported. They were initially managed with bilateral uterine artery ligation. The procedure was resorted to women who did not respond to ligation. The procedure is efficient. Women were followed up for up to 24 months to report any complications.

Cesarean section for obstructed labor remains a difficult procedure that may be associated with serious fetal and maternal injuries. In this case series, we evaluated the use of abdominal disimpaction with lower segment support as a novel technique to minimize morbidities. Eight patients who underwent cesarean section for obstructed labor were recruited. Impacted fetal head was delivered using this technique and uterine extensions, bladder injury, vaginal injury, and intraoperative bleeding were reported. Maternal and neonatal outcomes were observed postoperatively. No major morbidities were reported. Accordingly, we consider this technique as a promising step to minimize complications during cesarean section for obstructed labor.

Placenta accreta/percreta is a serious cause of intractable post-partum haemorrhage during caesarean section and acommon cause of peripartum hysterectomy. In this case series, we evaluated the use of multiple 8 sutures as a novelprocedure to preserve the uterus in these cases. Seven women with placenta accreta/percreta were initially managed withbilateral uterine artery ligation. The procedure was resorted to in cases that did not respond to ligation (five women).Women were followed up for up to 24 months to report complications.Key words: multiple 8 suture, placenta accreta, post-partum haemorrhage, transverse lower uterine segment suture.

Introduction Twin pregnancy with complete hydatidiform mole represents a very rare obstetric problem. Management of such cases is always problematic because the possibility of fetal survival should always be weighed against the risk of complications of molar pregnancy. Case presentation A 34-year-old Caucasian woman presented to our center with mild vaginal bleeding. Our patient was 16 weeks pregnant after a seven-year period of primary infertility. She became pregnant following a non-prescribed regimen of clomiphene citrate extending from the second day to the 13th day of her last cycle. A transabdominal ultrasound examination revealed a twin pregnancy with complete hydatidiform mole and a coexisting fetus. Serum β human chorionic gonadotropin was falsely low as identified by serial dilution of the sample (the 'hook effect'). Our patient refused termination of pregnancy and she was hospitalized for strict observation and follow-up. Unfortunately, she developed an attack of severe vaginal bleeding and a hysterotomy was performed. The fetus died shortly after birth. Conclusions Twin pregnancy with complete hydatidiform mole represents a matter of controversy. We suggest that conservation should always be considered whenever tertiary care services and strict observation are available.

OBJECTIVES Our study identifies vaginal douching as a risk factor for preterm labor and specifies the risk according to the method, frequency, nature, and timing of douching. MATERIALS AND METHODS This is a hospital-based case-control study. A total of 480 women were recruited. Women were classified into case group (history of preterm labor) and control group (no history of preterm labor). An interview questionnaire was administered, which included participants' data and criteria of douching practice. RESULTS Among participants who regularly douched (73.13%), 281 (80.06%) used it for cleanliness and religious considerations. Women who have been regularly douched were at higher risk of preterm labor (adjusted odds ratio [OR] = 1.9; 95% CI = 1.078-3.278; p = .026). The method (fingers vs pump) and the frequency of douching were significantly relevant. The risk of douching during pregnancy was borderline (adjusted OR = 2.1; 95% CI = 1.001-4.446; p =.05). Douching several times per day has an OR of 4.05 (95% CI = 1.196-13.737; p =.025) when compared with the monthly frequency. CONCLUSIONS Vaginal douching is associated with higher risk of preterm labor. We recommend that the risk of asymptomatic bacterial vaginosis should be considered.