Successful pregnancy after bilateral internal iliac artery ligation monitored by color Doppler imaging

Abstract

Ligation of the internal iliac (hypogastric) arteries can be a life-saving procedure in cases of severe hemorrhage from pelvic viscera. In young women it is the only way to preserve fertility when conservative methods have failed to control the bleeding. We present the case of a 21-year-old woman whose first pregnancy was terminated, after which profuse vaginal bleeding occurred and could not be controlled by conservative methods. An urgent laparotomy was performed and both internal iliac arteries were ligated. Two years after surgery, the patient conceived and after an uneventful pregnancy delivered a healthy infant. Uterine and fetal circulations were monitored with color Doppler imaging and were normal throughout pregnancy. A normal 3550-g male infant was delivered vaginally at 39 weeks' gestation.

Prediction of operation time for laparoscopic myomectomy by ultrasound measurements

“…However, uterine artery ligation is not recommended in women who might undergo subsequent childbirth [11]. Although successful pregnancies after bilateral ligation of hypogastric arteries have been reported [21,32], we performed uterine artery ligation [3] in only 13 patients with larger myoma sizes and who completed childbirth. Because of the small number of cases, we did not observe a significant amount of less bleeding in these cases.…”

Les hémorragies graves de la délivrance : doit-on lier, hystérectomiser ou emboliser ?

“…Les particules pour l'embolisation ou les fils pour les ligatures sont résorbables. La reprise des cycles est le plus souvent normale et plusieurs cas de grossesses après embolisation ou ligatures vasculaires ont été rapportés, même après exclusion des pédicules lomboovariens [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Il n'y a pas d'insuffisance utéroplacentaire constatée pour les grossesses ultérieures.…”

Hypogastric artery ligation for obstetrical hemorrhage: clinical experiencein a tertiary care center

“…It was suggested that HAL would block the blood flow to female pelvic organs completely; however, due to the anastomosis of the female pelvic vasculature, blood flow does not completely cease (22,23). It is well known that after a bilateral HAL, patients can achieve term pregnancies (24)(25)(26)(27).…”