[Ligation of internal iliac arteries for severe hemorrhage in obstetric]

AIM

To assess the efficiency of arteries ligation in intractable obstetrical hemorrhage.

METHODS

Prospective study which concerned 53 patients who underwent internal iliac arteries ligation for persistent and severe obstetrical hemorrhage from January 2007 to June 2010.

RESULTS

The average age of patients was 29.3 years. The mean parity was 2.2. Main etiology of hemorrhage were: uterine atony (62.2%), abruptio placentae (15.1%). Coagulation disorders and hypovolemic shock were observed respectively in 20.7 % and 37.7%. Blood transfusion was performed in all cases. Internal iliac arteries ligation allowed hemorrhage control in 90.5 % of cases. In five cases a hysterectomy was necessary to control bleeding.. No peroperative complication were observed.

CONCLUSION

Internal iliac arteries ligation is a prerequisite treatment of severe postpartum hemorrhage. It is a good alternative to arterial embolization.

[Obstetrical prognosis following ligation of hypogastric arteries]

BACKGROUND

Ligation of hypogastric arteries is a conservative surgical treatment in cases of postpartum hemorrhage.

AIM

To study the fertility and pregnancies outcome in women who required hypogastric artery ligation for severe post-partum haemorrhage in our hospital.

METHODS

The fertility and pregnancy outcome parameters were retrieved from medical files and telephone interviews

RESULTS

34 patients required hypogastric ligation on this period. 39 pregnancies were observed with 30 term deliveries, 1 ectopic pregnancies and 8 miscarriages. Two patients had infertility and pregnancy was obtained in less than 10 months most once desired.Pregnancy outcome was normal. 73,3% of deliveries were by caesarean.

CONCLUSION

Hypogastric artery ligation for post-partum haemorrhage is not responsible for secondary infertility. Following pregnancies do not suffer complications from the ligation.