Abstract
Background: Post Partum Hemorrhage (PPH) is a life threatening emergency that needs to be managed timely. Refractory PPH is treated surgically. Bilateral internal iliac artery ligation is one of the surgical procedures performed to control bleeding.Objective: We analyzed the effectiveness of Bilateral IIAL in controlling bleeding in PPHMethodology: It was a retrograde cross-sectional study conducted at Lady Aitchison hospital, Lahore from data during January 2018 to December 2020. After applying inclusion and exclusion criteria, data of patient including demographics, history, examination, ultrasound, procedure details and post-operative complications were recorded. All the data was analyzed using SPSS version 23.0.Results: All the patients (44) survived and success rate was 100 %. Uterine atony was present in 29 (65.9%) patients as a cause of PPH, placental abnormality, uterine rupture and coagulopathy in 7(15, 9), 4 (9.1%) and 4 (9.1%) patients respectively. 17 patients did not develop any complication. Most common Post-operative complication was wound infection (22.75%) followed by pneumonia (20.5%), paralytic ileus (9.1%) and DIC with renal failure (9.1%).Conclusion: Bilateral IIAL was found to be an effective and preferred life saving procedure, preserving fertility.  Â
Highlights
One of the most common obstetric emergencies is postpartum bleeding with the prevalence
Uterine atony is the causative factor in most of the cases of Post Partum Hemorrhage (PPH). [4] other notable causes include trauma, retained tissue, placental abnormality and bleeding or coagulation disturbances. [5,6,7,8] PPH can occur without any risk factor, a greater incidence has been reported in the pregnancies complicated by macrosomia, polyhydramnios and instrumental deliveries. [9], [10] Postpartum bleeding can lead to anemia, orthostatic hypotension, fatigue, depression, pituitary necrosis, myocardial ischemia, shock and death
All the cases in which bilateral iliac Artery. Ligation (IIAL) was performed by a Consultant Gynecologist having an experience of at least more than 5 years were collected from hospital record from January 2018 to December 2020
Summary
One of the most common obstetric emergencies is postpartum bleeding with the prevalence. [14], [15] To explore its outcome and complications further, we report a case series in which IIAL was employed to control PPH. Post Partum Hemorrhage (PPH) is a life threatening emergency that needs to be managed timely. Bilateral internal iliac artery ligation is one of the surgical procedures performed to control bleeding. Objective: We analyzed the effectiveness of Bilateral IIAL in controlling bleeding in PPH Methodology: It was a retrograde cross-sectional study conducted at Lady Aitchison hospital, Lahore from data during January 2018 to December 2020. After applying inclusion and exclusion criteria, data of patient including demographics, history, examination, ultrasound, procedure details and post-operative complications were recorded. Conclusion: Bilateral IIAL was found to be an effective and preferred life saving procedure, preserving fertility
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