The role of prophylactic internal iliac artery ligation in abnormally invasive placenta undergoing caesarean hysterectomy: a randomized control trial

Hussein, Ahmed M.; Dakhly, Dina M.R.; Raslan, Ayman N.; Hafeez, Ali Abdel; Moussa, Manal Abd Rabo; Hosny, Ahmed; Momtaz, M.

doi:10.1080/14767058.2018.1463986

Cited by 35 publications

(25 citation statements)

References 26 publications

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“…Our study found that using prophylactic IIAL has no statistically significant role in reducing the mean blood loss and the mean transfused blood products in placenta percreta patients before CH with the use of blunt dissection technique. These findings are compatible with those of former studies that examine utilizing prophylactic bilateral IIAL before CH in patients with abnormally invasive placenta [7,8] and only placenta percreta [9]. Kuhn et al retrospectively found that bilateral IIAL in patients with placenta percreta undergoing CH did not significantly decrease the amount of blood loss in 11 patients when compared to 26 patients without bilateral IIAL [9].…”

Section: Discussionsupporting

confidence: 88%

“…Although a hysterectomy is the most preferred surgical procedure [4], bilateral internal iliac artery ligation (IIAL) technique has been performed as a life-saving modality to decrease haemorrhage in obstetrical and pelvic surgeries when other commonly used surgical methods fail [5,6]. There are only a few studies about using bilateral IIAL during abnormally invasive placenta [7,8] and only placenta percreta surgery [9] which are mostly designed with a limited number of patients. Blunt dissection technique with index finger is a new surgical method to reduce bleeding in the vesico-uterine pouch and to avoid bladder injury during CH in patients with placenta percreta that invades posterior bladder wall [10].…”

Section: Introductionmentioning

confidence: 99%

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Is there a role of prophylactic bilateral internal iliac artery ligation on reducing the bleeding during cesarean hysterectomy in patients with placenta percreta? A retrospective cohort study

et al. 2021

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Objectives: Our study aims to evaluate the effect of bilateral prophylactic internal iliac artery ligation (IIAL) on bleeding in patients with placenta percreta who undergo cesarean hysterectomy (CH) with the use of blunt dissection technique. Material and methods:This retrospective cohort study included 96 patients with placenta percreta who underwent planned CH with using the blunt dissection technique to allow better vesico-uterine dissection at the gynecology and obstetrics unit of a university hospital between the years 2017-2019. We carried out bilateral IIAL before CH in the study group (group 1) while we performed only CH in the control group (group 2).Results: Group 1 and Group 2 consisted of 50 and 46 patients; respectively. There was no statistical difference between the two groups as regards to the mean estimated blood loss, the mean transfused blood products, the mean operation time, and the number of complications. In total, 24 patients (25%) had complications with the finding that the most common one was bladder injury (16/96, 16,66%). Conclusions:Routine bilateral prophylactic IIAL before CH in placenta percreta cases does not have a beneficial effect on decreasing the amount of bleeding and the amount blood transfusion

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Is there a role of prophylactic bilateral internal iliac artery ligation on reducing the bleeding during cesarean hysterectomy in patients with placenta percreta? A retrospective cohort study

et al. 2021

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“…Since balloon catheters and sheaths are inserted, it is easy to perform additional uterine artery embolization immediately in the case of uncontrolled bleeding after cesarean delivery. In contrast, bleeding control may take longer with surgical ligation use; thus, the prophylactic use of bilateral internal iliac artery ligation has been found to have limited advantages in the reduction of inter-operative bleeding rates [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Prophylactic Balloon-Assisted Occlusion of the Internal Iliac Arteries in the Management of Placenta Increta/Percreta

et al. 2020

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Background and Objectives: Preoperative prophylactic balloon-assisted occlusion (PBAO) of the internal iliac arteries minimizes blood loss and facilitates surgery performance, through reductions in the rate of uterine perfusion, which allow for better control in hysterectomy performance, with decreased rates of bleeding and surgical complications. We aimed to investigate the maternal and fetal outcomes associated with PBAO use in women with placenta increta or percreta. Material and Methods: The records of 42 consecutive patients with a diagnosis of placenta increta or percreta were retrospectively reviewed. Of 42 patients, 17 patients (40.5%) with placenta increta or percreta underwent cesarean delivery after prophylactic balloon catheter placement in the bilateral internal iliac artery (balloon group). The blood loss volume, transfusion volume, postoperative hemoglobin changes, rates of hysterectomy and hospitalization, and infant Apgar score in this group were compared to those of 25 similar women who underwent cesarean delivery without balloon placement (surgical group). Results: The mean intraoperative blood loss volume in the balloon group (2319 ± 1191 mL, range 1000–4500 mL) was significantly lower than that in the surgical group (4435 ± 1376 mL, range 1500–10,500 mL) (p = 0.037). The mean blood unit volume transfused in the balloon group (2060 ± 1154 mL, range 1200–8000 mL) was significantly lower than that in the surgical group (3840 ± 1464 mL, range 1800–15,200 mL) (p = 0.043). There was no significant difference in the postoperative hemoglobin change, hysterectomy rates, length of hospitalization, or infant Apgar score between the groups. Conclusion: PBAO of the internal iliac artery prior to cesarean delivery in patients with placenta increta or percreta is a safe and minimally invasive technique that reduces the rate of intraoperative blood loss and transfusion requirements.

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“…In low-resources countries, where IR is not available it has remained in use in particular in the context of uterine preservation in PAS. A recent RCT of bilateral internal iliac artery ligation (n= 29 cases) versus controls (n= 28 cases) reported no significant difference between the two groups regarding the intraoperative estimated blood loss (86).…”

Section: Additional Therapeutic Techniquesmentioning

confidence: 91%

New evidence-based diagnostic and management strategies for placenta accreta spectrum disorders

Jauniaux

Hussein

Fox

et al. 2019

Best Practice & Research Clinical Obstetrics & Gynaecol

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The role of prophylactic internal iliac artery ligation in abnormally invasive placenta undergoing caesarean hysterectomy: a randomized control trial

Abstract: Bilateral internal iliac artery ligation, in cases of AIP undergoing caesarean hysterectomy, is not recommended for routine practice to minimize blood loss intraoperatively.

Cited by 35 publications

References 26 publications

Is there a role of prophylactic bilateral internal iliac artery ligation on reducing the bleeding during cesarean hysterectomy in patients with placenta percreta? A retrospective cohort study

Is there a role of prophylactic bilateral internal iliac artery ligation on reducing the bleeding during cesarean hysterectomy in patients with placenta percreta? A retrospective cohort study

Preoperative Prophylactic Balloon-Assisted Occlusion of the Internal Iliac Arteries in the Management of Placenta Increta/Percreta

New evidence-based diagnostic and management strategies for placenta accreta spectrum disorders

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