Color Doppler analysis of pelvic arteries following bilateral internal iliac artery ligation for severe postpartum hemorrhage

Yıldırım, Yusuf; Gültekin, Emre; Koçyi̇ği̇t, Ali̇; Yılmaz, Cengiz; Ertopcu, Kenan; Ariöz, Dağıstan Tolga

doi:10.1016/j.ijgo.2008.08.031

Cited by 16 publications

(18 citation statements)

References 20 publications

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“…So, it may detect a decrease in ovarian perfusion. However, the ovarian function was maintained as suggested by spontaneous resumption of menstrual cycles within 6 months of IIAL in [23,24]. .…”

Section: Discussionmentioning

confidence: 99%

Ligating Internal Iliac Artery: Success beyond Hesitation

Singh

Kishore

Saxena

2016

J Obstet Gynecol India

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Aim To study the outcomes, benefits and complications of internal iliac artery ligation in both obstetric and gynecological cases.Objective To study the outcomes, effectiveness and complications of internal iliac artery ligation (IIAL). Method This is an analytical longitudinal study done among women who have undergone internal iliac artery ligation in Dr. BRAMH a tertiary referral center from July 2013 to June 2015. Follow-up was done through color Doppler analysis of pelvic arteries before discharge, after 6 weeks and after 6 months. Result The efficacy of IIAL was 96.87 %. The mean shock index was 0.94 ± 0.26. Sixty-four women underwent IIAL out of which placenta previa (21.8 %) was the major indication. There were four maternal deaths. There were no intraoperative or ischemic complications. The greater the time interval between onset of hemorrhage and IIAL, the graver the outcome. For all women in whom uterus could be salvaged, resumption of menstrual cycles was seen within 6 months of IIAL. There was a significant decrease in the RI and PI of uterine arteries. In the ovarian arteries, there was a significant increase in RI and no significant change in PI initially. Flow in distal part of ligated internal iliac arteries could be detected in 54 (90 %) women out of 60 after 6 months of ligation of internal iliac arteries. Conclusion IIAL is an effective life-saving method to control obstetric and gynecological hemorrhage, and a hysterectomy can often be avoided. Early resort to IIAL is vital for improving the patient outcome. Uterine perfusion is well maintained, while there may be a decrease in ovarian perfusion. Resumption of menstrual cycles and presence of distal flow in internal iliac artery within 6 months suggest the preservation of future fertility; in order to better understand the impact of IIAL on ovarian functions and future fertility, larger studies with longer follow-up periods need to be conducted.

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Section: Discussionmentioning

confidence: 99%

Ligating Internal Iliac Artery: Success beyond Hesitation

Singh

Kishore

Saxena

2016

J Obstet Gynecol India

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“…Still some investigators have claimed that this procedure has no unfavorable effect on ovarian functions, and complete consensus has not been reached on this issue (16,17) . In of the ovarian reserve (18) .…”

Section: Parameter Valuementioning

confidence: 99%

Efficacy of internal iliac artery ligation on the management of postpartum hemorrhage and its impact on ovarian reserve

Şimşek¹,

Yılmaz²,

Çelik³

et al. 2012

J Turk Soc Obstet Gynecol

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SUMMARY Aim Thirteen of those underwent the ligation of bilateral internal iliac artery. The mean age of 32 (24 -44), mean gravida 3,2 (1 -5), mean parity 2 (0 -4), mean birth week 38 (35 -41) and mean birth weight were 3373 g (2500 -4200). The effectiveness of bilateral internal iliac artery ligation was 84,7%. FSH and estradiol concentrations and the mean volume of the ovarieswere similar between the study (n:10) and control (n:56) groups (P= 0.650, P= 0.245 and P=0.281, respectively).

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“…Sentilhes et al concluent aussi à la sureté de la ligature des artères utérines isolées ou associées à une ligature des ligaments utero-ovariens sur la fertilité ultérieure et le déroulement des grossesses [5]. La mesure du Doppler utérin après ligature montre que la reperméabilisation survient en moyenne 5 mois [1-6] après la ligature [24]. De plus, les mesures de Doppler utérin ne semblent pas diffé-rentes après ligature par rapport à une population témoin [25,26].…”

Section: Discussionunclassified

“…Après ligature comme après embolisation, l'hypothèse du développement d'un réseau local d'anastomoses secondaire à l'occlusion vasculaire peut être évoquée, tout comme les conséquen-ces éventuelles d'une manipulation endo-utérine pouvant conduire à de minimes zones de placenta accreta ou encore l'altération de la capacité contractile du myomètre suite à l'hypoxie. Cependant, les études portant sur les Doppler des artères utérines concluent à la reperméabilisation pré-coce après ligature (aucune donnée n'étant disponible après embolisation) [24][25][26] ce qui n'est pas en faveur d'une alté-ration de la contractilité du myomètre.…”

Section: Discussionunclassified

Fertilité et grossesses après prise en charge invasive des hémorragies du postpartum

Capmas

Picone

Musset

et al. 2012

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

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Color Doppler analysis of pelvic arteries following bilateral internal iliac artery ligation for severe postpartum hemorrhage

Abstract: These findings are consistent with published data demonstrating that pelvic circulation is not compromised after bilateral internal iliac artery ligation.

Cited by 16 publications

References 20 publications

Ligating Internal Iliac Artery: Success beyond Hesitation

Ligating Internal Iliac Artery: Success beyond Hesitation

Efficacy of internal iliac artery ligation on the management of postpartum hemorrhage and its impact on ovarian reserve

Fertilité et grossesses après prise en charge invasive des hémorragies du postpartum

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