Abstract: Aim: To evaluate the role of Internal Iliac Artery Ligation (IIAL) as an alternative to pelvic devascularization and hysterectomy for obstetric haemorrhage and pelvic haemorrhage following gynaecological surgery.
Study design: Retrospective study performed over 25 women who underwent therapeutic IIAL/Pelvic devascularization to combat haemorrhage.
Study area: Santokba Durlabhji Memorial Hospital (SDMH), Jaipur from January 2016 to July 2020.
Study Sample: Women admitted to SDM Hospital, for obstetric or gynaecological intervention who underwent IIAL/Pelvic devascularization/Hysterectomy to combat haemorrhage.
Method: Bilateral or unilateral IIAL/ Pelvic devascularization performed.
Outcome: Need for hysterectomy following IIAL to combat haemorrahge or morbidity, mortality and complications following procedure.
Results: Total of 23 patients underwent IIAL, 16 bilateral and 7 unilateral. All ligations were done through a transperitoneal approach. 2 out of 23 ligations were performed for gynaecological indication. Out of 21 patients with obstetric complications, 9 underwent IIAL due to atonic postpartum haemorrhage, 2 for complete and 1 for incomplete placenta previa, 3 for placenta previa with adherent placenta, 2 for haemorrhagic shock in previous scar, 2 for uterine rupture.
Other 2 were done as there was an extension of uterine incision. There were 2 patients who underwent systemic devascularisation. Bleeding was controlled only in one case while other one required subtotal hysterectomy.
Conclusions: IIAL is an effective procedure to combat both obstetric and pelvic haemorrahge in a short span of time. Further it prevents women from undergoing hysterectomy and its following complications.
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