open access

Vol 91, No 1 (2020)
ORIGINAL PAPERS Obstetrics
Published online: 2020-01-31
Get Citation

Small invasive technique of Internal Iliac Artery ligation for postpartum haemorrhage

Grzegorz Raba
DOI: 10.5603/GP.2020.0007
·
Pubmed: 32039465
·
Ginekol Pol 2020;91(1):29-31.

open access

Vol 91, No 1 (2020)
ORIGINAL PAPERS Obstetrics
Published online: 2020-01-31

Abstract

Objectives: Internal Iliac artery ligation (IIAL) is an effective life-saving method to control obstetric hemorrhage, and a hysterectomy
can often be avoided. A standard ligation procedure requires wide tissues dissection: incision in the peritoneum
lateral to and parallel with the ureter. That can be traumatic and is difficult in practice what results in a rare use of IIAL in
surgical emergency. As an alternative a novel, small invasive technique was used, which protocol is attached to the paper
as a video presentation file.
Material and methods: Forty-five women treated by Internal Iliac Artery ligation for postpartum haemorrhage. In 27 patients
(Cohort A) standard IIAL procedure by Kelly’s method was used. In the remaining 18 patients (Cohort B) a novel, small
invasive technique was performed. Time of both surgical procedures of IIAL was measured.
Results: Time of Standard technique of IIAL vs Novel small invasive technique of IIAL: 34 (26–41) min. vs 13 (8–16) min. p < 0.001.
Conclusions: The presented novel small invasive technique of Internal Iliac artery ligation can be an easier and safe alternative
for standard ligation procedure.

Abstract

Objectives: Internal Iliac artery ligation (IIAL) is an effective life-saving method to control obstetric hemorrhage, and a hysterectomy
can often be avoided. A standard ligation procedure requires wide tissues dissection: incision in the peritoneum
lateral to and parallel with the ureter. That can be traumatic and is difficult in practice what results in a rare use of IIAL in
surgical emergency. As an alternative a novel, small invasive technique was used, which protocol is attached to the paper
as a video presentation file.
Material and methods: Forty-five women treated by Internal Iliac Artery ligation for postpartum haemorrhage. In 27 patients
(Cohort A) standard IIAL procedure by Kelly’s method was used. In the remaining 18 patients (Cohort B) a novel, small
invasive technique was performed. Time of both surgical procedures of IIAL was measured.
Results: Time of Standard technique of IIAL vs Novel small invasive technique of IIAL: 34 (26–41) min. vs 13 (8–16) min. p < 0.001.
Conclusions: The presented novel small invasive technique of Internal Iliac artery ligation can be an easier and safe alternative
for standard ligation procedure.

Get Citation

Keywords

postpartum hemorrhage; surgery; internal iliac artery

Supplementary Files (1)
Attachment
Download
56MB
About this article
Title

Small invasive technique of Internal Iliac Artery ligation for postpartum haemorrhage

Journal

Ginekologia Polska

Issue

Vol 91, No 1 (2020)

Pages

29-31

Published online

2020-01-31

DOI

10.5603/GP.2020.0007

Pubmed

32039465

Bibliographic record

Ginekol Pol 2020;91(1):29-31.

Keywords

postpartum hemorrhage
surgery
internal iliac artery

Authors

Grzegorz Raba

References (11)
  1. Bouet PE, Madar H, Froeliger A, et al. Surgical treatment of postpartum haemorrhage: national survey of French residents of obstetrics and gynecology. BMC Pregnancy Childbirth. 2019; 19(1): 91.
  2. Selçuk İ, Uzuner B, Boduç E, et al. Step-by-step ligation of the internal iliac artery. J Turk Ger Gynecol Assoc. 2019; 20(2): 123–128.
  3. Raba G, Baran P. Hemodynamic parameters following bilateral internal iliac arteries ligation as a treatment of intrapartum hemorrhage. Ginekol Pol. 2009; 80(3): 179–183.
  4. Kehila M, Derouich S, Chelli D, et al. Which surgical strategy to adopt for the management of postpartum haemorrhage and how to improve the effects of hypogastric arteries ligation? Pan Afr Med J. 2016; 25: 96.
  5. Kaya B, Usluogullari B, Yurttutan N, et al. Does ligation of internal iliac artery for postpartum hemorrhage affect clitoral artery blood flow and postpartum sexual functions? Eur J Obstet Gynecol Reprod Biol. 2017; 219: 124–128.
  6. Raba G. Internal iliac artery aneurysm after ligation for obstetric hemorrhage. Int J Gynaecol Obstet. 2009; 107(3): 249–250.
  7. Raba G. Effect of internal iliac artery ligation on ovarian blood supply and ovarian reserve. Climacteric. 2011; 14(1): 54–57.
  8. Kelly HA. Ligation of both Internal Iliac Arteries for Hæmorrhage in Hysterectomy for Carcinoma Uteri. Annals of Surgery. 1894; 20: 248.
  9. Royal College of Obstetricians and Gynaecologists. 2017.
  10. Raba G, Kotarski J, Szczupak K, et al. Uterus banding with the Osada method effectively reduces intraoperative blood loss during myomectomy. Minim Invasive Ther Allied Technol. 2016; 25(1): 43–47.
  11. Dohbit JS, Foumane P, Nkwabong E, et al. Uterus preserving surgery versus hysterectomy in the treatment of refractory postpartum haemorrhage in two tertiary maternity units in Cameroon: a cohort analysis of perioperative outcomes. BMC Pregnancy Childbirth. 2017; 17(1): 158.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl