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Updated: May 23, 2026

Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
[Ligation of internal iliac arteries for severe hemorrhage in obstetric]
Nabil Mathlouthi1, Belhassen Ben Ayed, Mohamed Dhouib
1Service de Gynécologie Obstétrique, CHU Hédi Chaker, Sfax, Tunisie.
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.
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