Clinical spectrum of internal iliac artery ligation in obstetrics and gynecology

Abstract

Objective: To study the role and efficacy of internal iliac artery ligation (IIAL) in obstetrics and gynaecology practice. Methods: Retrospective review of detailed clinical data of 89 women who underwent emergency or elective IIAL from January 2009 to December 2019 for any obstetrical or gynaecological indication at Shri Guru Ram Rai Institute of medical and health sciences, Dehradun, Uttarakhand. Results: Among 89 cases, 76 were done for obstetrical and 13 for gynaecological indication. Morbidly adherent placenta and uterine atony were the main indications for IIAL in obstetrics while radical hysterectomy in gynaecological cases. Our study shows a statistically significant (P value <0.005) correlation in the need for blood transfusion between elective versus emergency IIAL. Among 76 cases done for obstetrical indication, in 65.8% of cases uterus was saved emphasizing the importance of IIAL. Conclusion: IIAL is a safe, rapid and effective method of controlling pelvic haemorrhage during any emergency or elective pelvic surgery and it also prevents unnecessary hysterectomy in many obstetrical indications.

Keywords

• internal iliac artery ligation
• morbid adherent placenta
• postpartum haemorrhage
• hysterectomy