Hypogastric artery ligation for severe hemorrhage in obstetric patients
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Istvan Sziller
Abstract
Ligation of the hypogastric arteries (HAL) was first introduced into surgery by the end of the 19th century to control intractable hemorrhage from the uterus of women with advanced cervical cancer. At present, HAL is one in a spectrum of operative methods to control life-threatening postpartum hemorrhage before hysterectomy. Bilateral ligation of the internal iliac artery does not result in complete blockage of but to a significant decrease in blood supply to the female pelvic organs. Soon after ligation three previously existent collateral circulations will develop. Due to the smaller caliber of these arteries, the arterial pulse and pulse pressure are virtually eliminated. The effectiveness of HAL in avoiding hysterectomy for postpartum hemorrhage has been reported in up to 50% of cases. HAL has no adverse effect on subsequent fertility or pregnancy outcome, however, assessment for intrauterine fetal growth restriction is recommended. This safe and effective procedure should be taught during obstetric and gynecologic training.
©2007 by Walter de Gruyter Berlin New York
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- European consensus guidelines on the management of neonatal respiratory distress syndrome
- Hypogastric artery ligation for severe hemorrhage in obstetric patients
- Hypogastric artery ligation: a stitch in time
- Labor induction in preeclampsia: Is misoprostol more effective than dinoprostone?
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- Serratia marcescens bacteremia – an indicator for outbreak management and heightened surveillance
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