scholarly journals Role of bilateral internal iliac artery ligation in severe obstetric and gynaecological hemorrhage

2018 ◽  
Vol 7 (3) ◽  
pp. 1090 ◽  
Author(s):  
Shashi Lata Kabra Maheshwari ◽  
Nisha Kumari ◽  
Syed N. Ahmad
Keyword(s):  
Success Rate ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Care Hospital ◽  
Artery Ligation ◽  
Iliac Arteries ◽  
Internal Iliac Artery Ligation ◽  
Internal Iliac ◽  
Internal Iliac Arteries

Background: Massive pelvic haemorrhage is a potentially lethal complication while undergoing obstetric and gynaecological surgery. The objective of this study was to study of role of bilateral internal iliac artery ligation in severe obstetric and gynaecological haemorrhage. It was a prospective interventional study carried out in a multi-speciality tertiary care hospital in New Delhi.Methods: Thirty-five patients (31 obstetric and 4 gynaecological) fulfilling the inclusion criteria over a period of 2 years were included in the study cohort after informed consent. After laparotomy, internal iliac arteries were exposed by incising the peritoneal fold between the infundibulo-pelvic and round ligaments. A number 1 silk suture and right-angled artery forceps were used to tie the internal iliac arteries approximately 1 inch below their origin. The success and complications of the procedure were analysed.Results: In the present study 31 out of 35 cases underwent BIIAL for obstetrical cause of haemorrhage and rest 4 for gynaecological cause. In 19 out of 31 patients, hysterectomy preceded or followed BILAL depending upon the clinical situation making a uterine salvation rate of 38.7%. The success rate of BIIAL was 67.7% in 31 obstetric cases. In the 4 gynaecological cases BILAL was done to arrest post-hysterectomy haemorrhage and success rate was 100%. Among 35 patients one patient died of haemorrhagic shock and 4 other died of full blown sepsis and MODS in surgical ICU. No significant procedure related complications were encountered.Conclusions: BILAL is a very effective procedure to control PPH and pelvic haemorrhage due to other causes and helps save the much precious lives and uteri. This procedure can always be tried where procedures like embolization are unavailable.

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

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.

The Role of Bilateral Internal Iliac Artery Ligation in Minimizing Blood Loss Prior to Cesarean Hysterectomy Patients with Abnormally Invasive Placenta

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Magdy Mohamed kamal Yousef ◽  
Ahmed Mohamed Rateb ◽  
Ahmed Mohsen Hassan Mohamed
Keyword(s):  
Blood Loss ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Artery Ligation ◽  
Cesarean Hysterectomy ◽  
Internal Iliac Artery Ligation ◽  
Internal Iliac ◽  
Invasive Placenta ◽  
Abnormally Invasive Placenta

Abstract Background Abnormally invasive placenta (AIP) is a term that describes cases in which there is complete or partial failure of separation of the placenta from the uterine wall following delivery of the fetus. Objective to detect the role of bilateral internal iliac artery ligation in minimizing blood loss, prior to performing Cesarean Hysterectomy in cases with confirmed preoperative or intraoperative diagnosis of Abnormally invasive placenta. Patients and Methods The study was carried out at Ain shams university maternity hospital in 2019. Women were recruited from the labor ward who underwent CS Hysterectomy. The total number of pregnant women enrolled in the study was 95 women. Approval from the Medical Ethics Committee were obtained. Results Our study showed that internal iliac artery ligation in CS hysterectomy cases for AIP has non significant lower blood loss than cases who did not underwent internal iliac artery ligation. In stead, it had increased the operative time. In comparison of 45 patients underwent internal iliac artery ligation and 45 without ligation blood loss was non significantly lower in the group who underwent ligation with mean 1933 ml blood loss in comparison with 2117 ml in the group who did not. Conclusion Bilateral internal iliac artery ligation, in cases of AIP undergoing caesarean hysterectomy, is not recommended for routine practice to minimize blood loss intraoperatively.

Internal iliac artery ligation—a contemporary simplified approach

2021 ◽  
Author(s):  
Ari P. Sanders ◽  
Sebastian R. Hobson ◽  
Anna Kobylianskii ◽  
Jessica Papillon Smith ◽  
Lisa Allen ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Artery Ligation ◽  
Simplified Approach ◽  
Internal Iliac Artery Ligation ◽  
Internal Iliac

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

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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