How B-Lynch suture and bilateral internal iliac artery ligation saved the uterus of a young patient with severe postpartum haemorrhage

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.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.

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PROPHYLACTIC BILATERAL INTERNAL ILIAC ARTERY LIGATION, IN PREVENTION OF PPH, IN A CASE OF MULTIPLE LARGE INTRA MURAL FIBROIDS

10.36106/gjra/0410768 ◽

2021 ◽

pp. 83-84

Author(s):

Aditi Gaiwal ◽

Devdatta Dabholkar

Keyword(s):

Blood Loss ◽

Clinical Diagnosis ◽

Iliac Artery ◽

Postpartum Haemorrhage ◽

Internal Iliac Artery ◽

Artery Ligation ◽

Internal Iliac Artery Ligation ◽

Internal Iliac ◽

Excessive Blood Loss

Postpartum haemorrhage is dened as a blood loss of more than 500ml after delivery of the placenta. It is a clinical diagnosis that encompasses excessive blood loss after delivery of the baby from a variety of sites: uterus, cervix, 1 vagina and perineum

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Authors response to: Internal iliac artery ligation for arresting postpartum haemorrhage

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.2007.01361.x ◽

2007 ◽

Vol 114 (7) ◽

pp. 906-907

Keyword(s):

Iliac Artery ◽

Postpartum Haemorrhage ◽

Internal Iliac Artery ◽

Artery Ligation ◽

Internal Iliac Artery Ligation ◽

Internal Iliac

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Internal iliac artery ligation for arresting postpartum haemorrhage

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.2007.01360.x ◽

2007 ◽

Vol 114 (7) ◽

pp. 906-906

Keyword(s):

Iliac Artery ◽

Postpartum Haemorrhage ◽

Internal Iliac Artery ◽

Artery Ligation ◽

Internal Iliac Artery Ligation ◽

Internal Iliac

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Emergency bilateral internal iliac artery ligation in massive obstetric haemorrhage: 5 years experience At Tertiary Care Hospital.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.12.4360 ◽

2020 ◽

Vol 27 (12) ◽

pp. 2691-2695

Author(s):

Saadia Saleem ◽

Tasnim Tahira ◽

Naureen Javed ◽

Sumera Tahir

Keyword(s):

Retrospective Study ◽

Iliac Artery ◽

Internal Iliac Artery ◽

Tertiary Care ◽

Care Hospital ◽

Ureteric Injury ◽

Artery Ligation ◽

Internal Iliac Artery Ligation ◽

Obstetric Haemorrhage ◽

Internal Iliac

Objectives: To study the efficacy and safety of emergency bilateral internal iliac artery ligation (BIAL) in arresting massive obstetric haemorrahge. Study Design: Retrospective study. Setting: Department of Obstetrics and Gynaecology Unit-I, Allied Hospital, Faisalabad. Period: January 2014 to December 2018. Material & Methods: Fifty eight (58) patients with obstetric haemorrhage were included in this retrospective study. Bilateral internal iliac artery ligation was performed to control massive postpartum haemorrhage, post-operative internal haemorrhage. Results: The fifty eight (58) women underwent BIAl. Booked cases were onlhy (27%) and (73%) were unbooked. Out of 58 women 16(27%) women were with morbid adherent placenta, 14(24%) with uterine atony, 11(19%) uterine rupture, 9(17%) post-operative internal haemorrhage and 8(13%) coagulopathy were underwent BIAL. Out of 58 women 15(36%) ended in hysterectomy because of failure to control bleeding and uterus preserved in (64%). Overall efficacy in term of saving maternal life was 90%. One women had ureteric injury that was managed by Urologist. One another patient required re-laparotomy for persistant internal haemorrahge. Conclusion: Bilateral internal iliac artery ligation is safe and effective technique to control massive obstetric haemorrhage. Timely decision is also important to prevent hysterectomy. BIAL should include in algorithm to control intractable obstetric haemorrhage and consultant obstetricians and gynaecologist should learn that technique.

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