EC Gynaecology

Objective: The aim of the study was to assess the effectiveness of internal artery ligation (IIAL) in arresting and preventing postpartum haemorrhage (PPH) cases.

Design: Retrospective study carried out between December 2017 to December 2020 at Dr. Shankarrao Chavan Govt Medical College and Hospital, Nanded, Maharashtra.

Setting: Tertiary care hospital, Nanded, Maharashtra.

Method: Bilateral IIAL was performed in all women either through anterior or posterior approach.

Results: Out of 55 women who underwent IIAL, maximum number of therapeutic ligation were performed for placenta previa (27%) followed by atonic PPH (26%) and abruptio placentae (16%) respectively. Subtotal hysterectomy was performed after IIAL had failed to arrest haemorrhage in 9 (16.4%) of 55 women. Hysterectomy was more likely with uterine rupture (33.3%). Twenty six women needed only IIAL for control of PPH. Failure to control haemorrhage by IIAL was immediately evident and none of them required re-laparotomy. In none of the patients intra or postoperative complications were observed during or after procedure. The effectiveness of the study was evaluated in terms of uterine salvage rate and was found to be 84%.

Conclusion: Bilateral IIAL is considered to be safe and effective in managing cases of PPH and early resort to IIAL is the key to prevent PPH.

Keywords: Internal Iliac Artery Ligation; Obstetric Hysterectomies; Postpartum Haemorrhage

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