Role of bilateral internal iliac artery ligation in controlling refractory post partum hemorrhage

  • Authors

    • Samia Jamil King Edward Medical University, Lahore
    • sara Munir Shaikh Zayed Hospital, Lahore.
    • Javeria Amin Fatima Jinnah Medical University, Lahore
    • Shazia Nourin King Edward Medical University, Lahore
    • Alia . King Edward Medical University, Lahore
    • Zill e huma Amna Inayut Medical College, Lahore
    • Hamza Saeed Khokhar King Edward Medical University, Lahore
    • Sultan Ul Moazzam King Edward Medical University, Lahore
    • Muhammad Sohail Afzal University of Management and Technology, Lahore
    2021-09-08
    https://doi.org/10.14419/ijm.v9i2.31693
  • Refractory Post Partum Hemorrhage, Internal Iliac Artery Ligation, Post-Operative Complications.

  • Abstract

    Background: Post Partum Hemorrhage (PPH) is a life threatening emergency that needs to be managed timely. Refractory PPH is treated surgically. Bilateral internal iliac artery ligation is one of the surgical procedures performed to control bleeding.

    Objective: We analyzed the effectiveness of Bilateral IIAL in controlling bleeding in PPH

    Methodology: It was a retrograde cross-sectional study conducted at Lady Aitchison hospital, Lahore from data during January 2018 to December 2020. After applying inclusion and exclusion criteria, data of patient including demographics, history, examination, ultrasound, procedure details and post-operative complications were recorded. All the data was analyzed using SPSS version 23.0.

    Results: All the patients (44) survived and success rate was 100 %. Uterine atony was present in 29 (65.9%) patients as a cause of PPH, placental abnormality, uterine rupture and coagulopathy in 7(15, 9), 4 (9.1%) and 4 (9.1%) patients respectively. 17 patients did not develop any complication. Most common Post-operative complication was wound infection (22.75%) followed by pneumonia (20.5%), paralytic ileus (9.1%) and DIC with renal failure (9.1%).

    Conclusion: Bilateral IIAL was found to be an effective and preferred life saving procedure, preserving fertility.

     

     


     

  • References

    1. [1] Sentilhes L, Merlot B, Madar H, Sztark F, Brun S, Deneux-Tharaux C. Postpartum haemorrhage: prevention and treatment. Expert review of hematology. 2016 Nov 1;9(11):1043-61. https://doi.org/10.1080/17474086.2016.1245135.

      [2] World Health Organization. WHO recommendations for the prevention and treatment of postpartum haemorrhage. World Health Organization; 2012.

      [3] Ford JB, Patterson JA, Seeho SK, Roberts CL. Trends and outcomes of postpartum haemorrhage, 2003-2011. BMC pregnancy and childbirth. 2015 Dec;15(1):1-0. https://doi.org/10.1186/s12884-015-0788-5.

      [4] Lutomski JE, Byrne BM, Devane D, Greene RA. Increasing trends in atonic postpartum haemorrhage in Ireland: an 11â€year populationâ€based cohort study. BJOG: An International Journal of Obstetrics & Gynaecology. 2012 Feb;119(3):306-14. https://doi.org/10.1111/j.1471-0528.2011.03198.x.

      [5] Chandraharan E, Krishna A. Diagnosis and management of postpartum haemorrhage. Bmj. 2017 Sep 27;358. https://doi.org/10.1136/bmj.j3875.

      [6] Mousa HA, Blum J, Abou El Senoun G, Shakur H, Alfirevic Z. Treatment for primary postpartum haemorrhage. Cochrane database of systematic reviews. 2014(2). https://doi.org/10.1002/14651858.CD003249.pub3.

      [7] Wu S, Kocherginsky M, Hibbard JU. Abnormal placentation: twenty-year analysis. American journal of obstetrics and gynecology. 2005 May 1;192(5):1458-61. https://doi.org/10.1016/j.ajog.2004.12.074.

      [8] Calvert C, Thomas SL, Ronsmans C, Wagner KS, Adler AJ, Filippi V. Identifying regional variation in the prevalence of postpartum haemorrhage: a systematic review and meta-analysis. PloS one. 2012 Jul 23;7(7):e41114. https://doi.org/10.1371/journal.pone.0041114.

      [9] Briley A, Seed PT, Tydeman G, Ballard H, Waterstone M, Sandall J, Poston L, Tribe RM, Bewley S. Reporting errors, incidence and risk factors for postpartum haemorrhage and progression to severe PPH: a prospective observational study. BJOG: An International Journal of Obstetrics & Gynaecology. 2014 Jun;121(7):876-88. https://doi.org/10.1111/1471-0528.12588.

      [10] Davey MA, Flood M, Pollock W, Cullinane F, McDonald S. Risk factors for severe postpartum haemorrhage: A populationâ€based retrospective cohort study. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2020 Aug;60(4):522-32. https://doi.org/10.1111/ajo.13099.

      [11] Reyal F, Deffarges J, Luton D, Blot P, Oury JF, Sibony O. Severe post-partum hemorrhage: descriptive study at the Robert-Debre Hospital maternity ward. Journal de gynecologie, obstetrique et biologie de la reproduction. 2002 Jun 1;31(4):358-64.

      [12] Weeks AD. Recent advances in understanding the enduring nand deadly complication of postpartum haemorrhage Preface. Best Practice & Research Clinical Obstetrics & Gynaecology. 2019;61:1-2. https://doi.org/10.1016/j.bpobgyn.2019.08.005.

      [13] Rani PR, Begum J. Recent advances in the management of major postpartum haemorrhage-a review. Journal of clinical and diagnostic research: JCDR. 2017 Feb;11(2):QE01. https://doi.org/10.7860/JCDR/2017/22659.9463.

      [14] Joshi VM, Otiv SR, Majumder R, Nikam YA, Shrivastava M. Internal iliac artery ligation for arresting postpartum haemorrhage. BJOG: An International Journal of Obstetrics & Gynaecology. 2007 Mar;114(3):356-61. https://doi.org/10.1111/j.1471-0528.2006.01235.x.

      [15] Iwata A, Murayama Y, Itakura A, Baba K, Seki H, Takeda S. Limitations of internal iliac artery ligation for the reduction of intraoperative hemorrhage during cesarean hysterectomy in cases of placenta previa accreta. Journal of Obstetrics and Gynaecology Research. 2010 Apr;36(2):254-9. https://doi.org/10.1111/j.1447-0756.2009.01157.x.

      [16] Madhubala M. Bilateral Internal Iliac Artery Ligation, a Rational Choice of Surgery in Placenta Previa, a Hospital-Based Retrospective Study on the Prevention of Hysterectomy and Control of Postpartum Hemorrhage. The Journal of Obstetrics and Gynecology of India. 2019 Dec;69(6):535-40. https://doi.org/10.1007/s13224-019-01258-8.

      [17] Camuzcuoglu H, Toy H, Vural M, Yildiz F, Aydın H. Internal iliac artery ligation for severe postpartum hemorrhage and severe hemorrhage after postpartum hysterectomy. Journal of Obstetrics and Gynaecology Research. 2010 Jun; 36(3):538-43. https://doi.org/10.1111/j.1447-0756.2010.01198.x.

      [18] Evsen MS, Sak ME, Soydinc HE, Basaranoglu S, Bakir C, Sak S, Gul T. Internal iliac artery ligation for severe postpartum hemorrhage. Ginekologia polska. 2012; 83(9).

      [19] Simsek Y, Yilmaz E, Çelik E, Karaer IT, Turhan U, Celik O. Efficacy of internal iliac artery ligation on the management of postpartum hemorrhage and its impact on the ovarian reserve. J Turk soc obstet Gynecol. 2012;9(3):153-8. https://doi.org/10.5505/tjod.2012.26576.

      [20] Kaya B, Damarer Z, Daglar K, Unal O, Soliman A, Guralp O. Is there yet a role for internal iliac artery ligation in obstetric hemorrhage with the current gain in popularity of other uterus sparing techniques?. The journal of maternal-fetal & neonatal medicine. 2017 Jun 3;30(11):1325-32. https://doi.org/10.1080/14767058.2016.1212333.

      [21] Kaya B, Usluogullari B, Yurttutan N, Sahan MH, Güralp O, Malik E. Does ligation of internal iliac artery for postpartum hemorrhage affect clitoral artery blood flow and postpartum sexual functions?. European journal of obstetrics & gynecology and reproductive biology. 2017 Dec 1;219:124-8. https://doi.org/10.1016/j.ejogrb.2017.10.029.

  • Downloads

  • How to Cite

    Jamil, S., Munir, sara, Amin, J., Nourin, S., ., A., e huma, Z., Saeed Khokhar, H., Ul Moazzam, S., & Sohail Afzal, M. (2021). Role of bilateral internal iliac artery ligation in controlling refractory post partum hemorrhage. International Journal of Medicine, 9(2), 71-74. https://doi.org/10.14419/ijm.v9i2.31693

    Received date: 2021-07-13

    Accepted date: 2021-08-11

    Published date: 2021-09-08