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Ligation of internal iliac arteries for control of pelvic haemorrhage
Y S Nandanwar1, L Jhalam, N Mayadeo
1Dept of Gynaecology and Obstetrics, KEM Hospital, Parel, Bombay, Maharashtra.
Insights
Internal iliac ligation (IAL) is a procedure to control severe hemorrhage. This review of 46 cases found hysterectomy was often needed alongside IAL for effective hemorrhage control in gynecological and obstetric emergencies.
Area of Science:
- Obstetrics and Gynecology
- Vascular Surgery
Background:
- Hemorrhage remains a significant cause of maternal morbidity and mortality.
- Internal iliac ligation (IAL) is a recognized surgical technique to manage life-threatening pelvic hemorrhage.
- Effectiveness and complications of IAL require ongoing evaluation in diverse clinical scenarios.
Purpose of the Study:
- To retrospectively review the outcomes of internal iliac ligations (IAL) performed over a three-year period.
- To evaluate the effectiveness of IAL in managing gynecological and obstetric hemorrhage.
- To compare IAL efficacy in different clinical situations and consider alternative treatments.
Main Methods:
- Retrospective chart review of all internal iliac ligation (IAL) procedures.
- Analysis of 46 cases encompassing both gynecological and obstetric indications.
- Documentation of intra-operative and post-operative complications.
- Comparative effectiveness review and consideration of alternative management strategies.
Main Results:
- A total of 46 internal iliac ligations (IAL) were performed.
- Hysterectomy was frequently required as an adjunct procedure to achieve hemostasis.
- Intra-operative and post-operative complications were recorded and analyzed.
Conclusions:
- Internal iliac ligation (IAL) is a valuable tool for pelvic hemorrhage control in obstetrics and gynecology.
- Adjunctive procedures, such as hysterectomy, may be necessary for definitive hemorrhage management.
- Further comparative studies are warranted to optimize treatment strategies for severe pelvic bleeding.
Abstract:
This is a retrospective review of the internal iliac ligations (IAL) done over a period of 3 years. Both gynaecological and obstetric cases were considered. A total of 46 ligations were performed. The additional treatment required was hysterectomy to control haemorrhage. Intra-and post-operative complications were noted. A comparative review of the effectiveness of IAL in different situations is done and alternative modalities of treatment are considered.