scholarly journals Surgical hemostasis for obstetric hemorrhage: experimental and clinical studies

2020 ◽  
Vol 11 (3) ◽  
pp. 20-26
Author(s):  
M. R. Kantsurova ◽  
A. N. Rymashevsky
Keyword(s):  
Clinical Research ◽  
Experimental Work ◽  
Clinical Studies ◽  
Historical Development ◽  
Review Of The Literature ◽  
Obstetric Hemorrhage ◽  
Iliac Arteries ◽  
Uterine Arteries ◽  
Internal Iliac ◽  
Internal Iliac Arteries

The article presents a review of the literature on the problems of treatment of obstetric bleeding in the light of historical development and modern opportunities. Currently existing options for surgical hemostasis: ligation of pelvic vessels, ligation of internal iliac arteries, embolization of uterine arteries and compression sutures on the uterus are considered from the perspective of experimental work and clinical research. The paper reflects the opinions of domestic and foreign scientists, which were a vector for further study and experiments.

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.

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