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

Manickavasagam, Madhubala

doi:10.1007/s13224-019-01258-8

Cited by 6 publications

(10 citation statements)

References 18 publications

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“…However, AIP is a life-threatening pregnancy complication because it may cause catastrophic hemorrhage as a result of the deep invasion of the villi into the musculature and surrounding organs, resulting in high maternal mortality and hysterectomy rates. hemorrhage in obstetrical surgeries when other commonly used surgical methods fail 8,9 and remained the main strategy of AIP in areas where resources are limited even though its effectiveness is controversial. [17][18][19][20] Iwata et al 17 reported that ligation of IIA did not significantly contribute to hemostasis in cases of placenta previa accreta.…”

Section: Discussionmentioning

confidence: 99%

“…By comparison, IIA ligation has the advantage of being inexpensive, available in resource-scarce areas, and can be performed within 10 min by an experienced surgeon. 8,9 Papillon-Smith et al 25 traditionally described, vascular clamps were used in our study group to occlude the vessels. There is no need for peritoneal dissection or vessel skeletonization during the use of the vascular clamp.…”

Section: Discussionmentioning

confidence: 99%

“…Internal iliac artery (IIA) occlusion is performed as a life-saving method to reduce uterine blood perfusion, especially in settings where resources are limited and in cases where other conservative techniques fail. 8,9 However, there is to date no consensus on its safety and effectiveness in patients with AIP. The present study aimed to investigate the clinical effect of IIA intraoperative temporary occlusion in AIP.…”

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confidence: 99%

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The role of internal iliac artery intraoperative vascular clamp temporary occlusion in abnormally invasive placenta

Yang

Yin

et al. 2022

Intl J Gynecology & Obste

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Objective To investigate the efficacy of internal iliac artery intraoperative vascular clamp temporary occlusion in the treatment of abnormally invasive placenta. Method This retrospective study enrolled 153 patients diagnosed with abnormally invasive placenta between January 2018 and December 2021. The patients were divided into a study group (n = 88, undergoing cesarean section followed by internal iliac artery vascular clamp temporary occlusion) and a control group (n = 65, receiving routine cesarean section). The general situation, intraoperative conditions, postoperative complications, and neonatal outcomes were compared between the two groups. Results The hysterectomy rate in the study group was significantly lower than that in the control group. However, there were no significant differences in intraoperative blood loss, blood transfusion, postoperative intensive care unit transfer rate, or neonatal outcome between the groups. Further subgrouping showed that in patients with placenta increta, the hysterectomy rate and intraoperative bleeding amount were significantly lower in the occlusion group. Nevertheless, these advantages were not significantly different between the groups in patients with placenta percreta. Conclusion Vascular clamp temporary occlusion of internal iliac artery is an effective method for controlling hemorrhage and decreasing the incidence of hysterectomy in patients with placenta increta. For patients with placenta percreta, the benefit is limited.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The role of internal iliac artery intraoperative vascular clamp temporary occlusion in abnormally invasive placenta

Yang

Yin

et al. 2022

Intl J Gynecology & Obste

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“…However studies with widely varied results have also been reported. [14][15][16][17][18][19] Mode of delivery was c-section in half (50%) of the patients and vaginal delivery in remaining half. This fact is quiet contrasting to data from a study of European country where C-section percentages were higher than our study.…”

Section: Discussionmentioning

confidence: 99%

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

Jamil

Munir

Amin

et al. 2021

IJM

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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 PPHMethodology: 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.

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“…To control PPH, ligation of internal iliac artery (IILA) was first extensively investigated in 1968 by Burchell RC, which introduced a new era for the management of PPH by conserving reproductive potential of women. 1,7,8 Bilateral internal iliac artery ligation decreases 45% pelvic blood flow and decreases 85% pulse pressure 9 that result in transformation of pelvic artery into venous like system, thereby converting to the venous pressure in the arterial circuit and that promotes haemostasis. It is reported that success of internal iliac artery ligation varies from 42% to 100% and it proves useful to avoid hysterectomy in substantial number of cases.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Internal iliac artery ligation: A life saving conservative management to control postpartum haemorrhage- clinical experiences

Das

Bhattacharyya²

2022

PJMS

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It has been since long, that severe postpartum haemorrhage (PPH) was surgically treated by peripartum hysterectomy. Bilateral ligation of Internal iliac artery is an emerging technique by which we can control PPH efficiently and can conserve uterus. The aim of our study, is to estimate the effectiveness of bilateral Internal iliac artery ligation (IILA) for conservation of uterus in the management of postpartum haemorrhage and outcome on the patients.This observational study was carried out on the admitted patients in between March, 2016 and February, 2020in a hospital having a tertiary obstetric care. Internal iliac artery ligation done to control postpartum haemorrhage of hospital admitted patients, was our study subject. Collected data were analysed in mean, median, percentage and proportion as applicable by using of SPSS version 24 statistical software.In the study population, out of forty-one patients, uterine conservation was possible in thirty-six (87.8%) patients. Most commonly sixteen (39%) patients had an indication of uterine atony for Internal iliac artery ligation. Caesarean section, thirty-four (82.9%) was the most common mode of delivery and general anaesthesia was used most commonly, thirty-seven (90.2%) for Internal iliac artery ligation. Procedure related complications were e.g. relaparotomy one (2.4%), Internal iliac vein injury two (4.9%) and wound infection two (4.9%).Internal iliac artery ligation is an effective means to control PPH. It can effectively preserve reproductive potential of women by avoiding peripartum hysterectomy in many cases. Postpartum hemorrhage is a life threatening complication of child birth. Peripartum hysterectomy is the last resort to tackle such complications. Our study, confirmed that bilateral internal iliac artery ligation can be a good alternative to tackle such disaster from postpartum hemorrhage and also conserve uterus of women for future reproduction.

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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

Cited by 6 publications

References 18 publications

The role of internal iliac artery intraoperative vascular clamp temporary occlusion in abnormally invasive placenta

The role of internal iliac artery intraoperative vascular clamp temporary occlusion in abnormally invasive placenta

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

Bilateral Internal iliac artery ligation: A life saving conservative management to control postpartum haemorrhage- clinical experiences

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