Hemodynamic parameters following bilateral internal iliac arteries ligation as a treatment of intrapartum hemorrhage

Abstract

Abstract Objective: The internal iliac arteries ligation (IIAL) is a particularly effective method, maintaining fertility, of dealing with intrapartum hemorrhage. Aim: Hemodynamic evaluation of the ovarian arteries(OA) and uterine arteries (UA) in patients after IIAL. Material: Study Group consisted of 6 women who underwent IIAL to treat intrapartum hemorrhage – without hysterectomy. Control Group consisted of 6 women, at the same age group, parity and time after delivery, who did not undergo IIAL. Method: Perfusion characteristics were studied by means of a transvaginal Doppler system. Resistance index (RI), pulsatility index (PI) and systolic/diastolic ratio(S/D) were measured in the uterine and ovarian arteries. Nonparametric comparison of the two groups was performed with the help of Two-sample Wilcoxon rank-sum (Mann-Whitney) test. Results: 1. Change of perfusion in OA- PI: 1.40 vs. 3.76 Prob <0.05; RI: 0.86 vs. 0.91 Prob >0.05; S/D: 3.25 vs. 18.2 Prob <0.05. 2. Change of perfusion in UA- PI: 2.20 vs. 2,75 Prob >0,05; RI 0.82 vs. 0.86 Prob >0.05; S/D: 5.28 vs. 7.81 Prob >0.05. Conclusions: 1. IIAL as a way of treating intrapartum haemorrhage, causes the decrease of pulsatility index(PI) and systolic/diastolic ratio (S/D) in ovarian arteries. 2. Characteristic changes of PI, RI and S/D parameters in uterine arteries after IIAL have not been observed. 3. Changes of ovarian flow velocity parameters suggest the possibility of changes in the ovarian function.