Hypogastric artery ligation in postpartum haemorrhage: a ten-year experience at a tertiary care centre

İçen, Mehmet Sait; Fındık, Fatih Mehmet; Evsen, Gamze Akin; Ağaçayak, Elif; Evsen, Mehmet Sıddık; Gül, Talip

doi:10.1080/01443615.2020.1755623

Cited by 10 publications

(9 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study in two patients (2.6%) hysterectomy was done due to intractable postpartum hemorrhage and was one female (1.3%) was died due to disseminated intravascular coagulation. Consistently İçen MS et al 16 reported that the rate of mortality was higher among referral cases as 10.25%, while the mortality rate was only 1.01% in female's cases who gave births at the hospital and further, they stated that the BHAL, is the best management option, which can be applied in all the cases of post-partum hemorrhage, because it is a good fertility-preserving method. However, it only preserves the fertility of cases, but also gives the higher survival.…”

Section: Resultsmentioning

confidence: 75%

“…However, it only preserves the fertility of cases, but also gives the higher survival. 16 Bailit et al 17 demonstrated that the cases of placenta accrete had the requirement of hysterectomy was 92%. However, obstetric hysterectomy is the major operative method for uncontrolled hemorrhage and also significantly linked to neonatal and maternal morbidity and mortality throughout the world.…”

Section: Resultsmentioning

confidence: 99%

“…However, obstetric hysterectomy is the major operative method for uncontrolled hemorrhage and also significantly linked to neonatal and maternal morbidity and mortality throughout the world. 18 İçen MS et al 16 reported that 2 cases underwent hysterectomy due to vaginal bleeding recurrence at 4-hour post-BHALs. In cases of intractable hemorrhage however internal iliac ligation or hysterectomy is necessary to control bleeding 16…”

Section: Resultsmentioning

confidence: 99%

“…18 İçen MS et al 16 reported that 2 cases underwent hysterectomy due to vaginal bleeding recurrence at 4-hour post-BHALs. In cases of intractable hemorrhage however internal iliac ligation or hysterectomy is necessary to control bleeding 16…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Role of the Uterine Artery Ligation (UAL) In Control of Postpartum Hemorrhage

Shaikh

et al. 2021

Ann Pak Inst Med Sci

View full text Add to dashboard Cite

Objective: To determine the efficacy and safety of uterine artery ligation (UAL) in control of Postpartum Hemorrhage. Methodology: This case series study was conducted at Department of Gynecology and Obstetrics Peoples University of Medical & Health Sciences for Women Nawabshah. All the women age between 20-45 years, gestation duration at and beyond 34 weeks, antepartum hemorrhage; intraoperative atonic postpartum hemorrhage and discovery of a placenta accreta; or an adherent placental part after piecemeal removal of the placenta, with bleeding from the placental site were included. After failure of treatment from medical measures, the initial surgical approach of uterine artery ligation (UAL) was done. Efficacy was defined as positive when patient improves or clinically doesn’t develop any complication throughout admission after UAL. Safety was assessed by appearance of side effects if any occurred after procedure. Data was recorded via study proforma and analysis was done by using SPSS version 20. Results: Out of 76 patients admitted of postpartum hemorrhage mean age was 58 years. Most of the patients 59.2% were multiparous and 40.8% were primiparous. The most common cause of postpartum hemorrhage was uterine atony 56.5% and adherent Placenta accreta 43.42%. Most of the patients 81.6% had no postoperative complications except for 11 patients, who had developed gaping of the wound from which they recovered and discharged. The patients required hysterectomy due to intractable hemorrhage and 2.3% mortality was observed due to DIC. Conclusion: Uterine devascularization by bilateral uterine artery ligation is a simple, effective and the safest initial surgical option with less blood loss and less surgical time for controlling postpartum hemorrhage during cesarean section. It should be used as the first surgical step of choice after medical managements fail in controlling postpartum hemorrhage due to minimal rate of complications and mortality.

show abstract

Section: Resultsmentioning

confidence: 75%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Role of the Uterine Artery Ligation (UAL) In Control of Postpartum Hemorrhage

Shaikh

et al. 2021

Ann Pak Inst Med Sci

View full text Add to dashboard Cite

show abstract

“…The mortality rate among patients referred from a first or second level of care is 10.25%, while this rate is 1.11% among patients who were initially treated at a third level of care. In our case, the patient came from the beginning to our 3rd level institution [11].…”

Section: Discussionmentioning

confidence: 96%

Bilateral Ligation of the Anterior Branch of the Hypogastric Artery in Massive Obstetric Hemorrhage Secondary to Septic Abortion (Case Report)

Juarez¹,

Juarez²,

Herandez³

et al. 2021

JGO

View full text Add to dashboard Cite

Hemorrhage is the main cause of Maternal Mortality (MM) (27%) followed by hypertensive disorders and sepsis (12%). Septic abortion is considered an intermediate risk factor for the development of Massive Obstetric Hemorrhage (MOH). The algorithm for the management of postpartum hemorrhage due to uterine atony that includes systematic pelvic devascularization has been described, but this management is really planned for resolution of the pregnancy after the 20th week of gestation, since an HMO due to abortion is un usual. We present the case of a 21-year-old patient who self-medicates a prostaglandin analog at 2 months of pregnancy, achieving only a threat of abortion, goes to the emergency room 3 months later with a diagnosis of septic shock, USG and MRI are performed with altered results, only of hepatomegaly, delayed abortion of 8 weeks of evolution and gestational trophoblastic disease. Emergency MVA was performed due to profuse bleeding, placement of a Bakri balloon and clamping of the uterine arteries without results, for which an emergency exploratory laparotomy (LAPE) was performed with ligation of the anterior trunk of the internal iliac artery, being a successful procedure, without the need for Obstetric Hysterectomy (HO). The patient is managed in intensive care and in the end the diagnosis of TSG is ruled out. Bilateral Hypogastric Artery Ligation (BHAL) in the case of Massive Obstetric Hemorrhage (MOH) secondary to delivery or cesarean section is commonly used, however it is not a technique to report when bleeding is secondary to abortion. In these cases, it is also a viable, successful, fertility-preserving surgical procedure, and an alternative to Obstetric Hysterectomy (OH) when other less invasive methods such as uterine artery clamping or Bakri balloon have failed.

show abstract