Successful pregnancy after bilateral internal iliac artery ligation monitored by color Doppler imaging

Ligation of the internal iliac (hypogastric) arteries can be a life-saving procedure in cases of severe hemorrhage from pelvic viscera. In young women it is the only way to preserve fertility when conservative methods have failed to control the bleeding. We present the case of a 21-year-old woman whose first pregnancy was terminated, after which profuse vaginal bleeding occurred and could not be controlled by conservative methods. An urgent laparotomy was performed and both internal iliac arteries were ligated. Two years after surgery, the patient conceived and after an uneventful pregnancy delivered a healthy infant. Uterine and fetal circulations were monitored with color Doppler imaging and were normal throughout pregnancy. A normal 3550-g male infant was delivered vaginally at 39 weeks' gestation.