Ligation of internal iliac arteries for severe hemorrhage in obstetric

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Published Apr 3, 2012
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Vol. 90 No. 3 (2012): Issue Mar 2012

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Nabil Mathlouthi
Belhassen Ben Ayed
Mohamed Dhouib
Kaies Chaabene
Khaled Trabelsi
Mohamed Ayadia
Kamel Kolsi
Habib Amouri
Mohamed Guermazi

Abstract

Aim: To assess the efficiency of arteries ligation in intractable obstetrical hemorrhage.
Methods: Prospective study which concerned 53 patients who underwent internal iliac arteries ligation for persistent and severe obstetrical hemorrhage from January 2007 to June 2010.
Results: The average age of patients was 29.3 years. The mean parity was 2.2. Main etiology of hemorrhage were: uterine atony (62.2%), abruptio placentae (15.1%). Coagulation disorders and hypovolemic shock were observed respectively in 20.7 % and 37.7%. Blood transfusion was performed in all cases. Internal iliac arteries ligation allowed hemorrhage control in 90.5 % of cases. In five cases a hysterectomy was necessary to control bleeding.. No peroperative complication were observed.
Conclusion: Internal iliac arteries ligation is a prerequisite treatment of severe postpartum hemorrhage. It is a good alternative to arterial embolization.

Keywords:

Postpartum hemorrhage; Internal iliac artery; Hysterectomy; Complications.

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