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

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.

Author(s):  
Shashi Lata Kabra Maheshwari ◽  
Nisha Kumari ◽  
Syed N. Ahmad

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.


2021 ◽  
Vol 14 (8) ◽  
pp. e244226
Author(s):  
San San Win ◽  
Helen Benedict Lasimbang ◽  
Sai Nay Lynn AUng ◽  
Tat Boon Yeap

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.


Author(s):  
Ari P. Sanders ◽  
Sebastian R. Hobson ◽  
Anna Kobylianskii ◽  
Jessica Papillon Smith ◽  
Lisa Allen ◽  
...  

2021 ◽  
pp. 83-84
Author(s):  
Aditi Gaiwal ◽  
Devdatta Dabholkar

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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