ROLE OF BILATERAL INTERNAL ILIAC ARTERY LIGATION IN OBSTETRIC HAEMORRHAGE COULD NOT BE FORGOTTEN, A HOSPITAL BASED CROSS SECTIONAL STUDY.

Dr Malay Sarkar; Dr Dibyendu Roy; Dr Jaydeb Mandal

Volume : IX, Issue : I, January - 2020

ROLE OF BILATERAL INTERNAL ILIAC ARTERY LIGATION IN OBSTETRIC HAEMORRHAGE COULD NOT BE FORGOTTEN, A HOSPITAL BASED CROSS SECTIONAL STUDY.

Dr Malay Sarkar, Dr Dibyendu Roy, Dr Jaydeb Mandal

Abstract :

Background : Post partum haemorrhage (PPH) is one of the major causes of maternal death in our country. Hystrectomy operation is frequently done in the management of intractable PPH. Objectives : Study of the role of internal iliac artery ligation in intractable PPH with preservation of Reproductive function. Methodology : This observational cross sectional study was conducted in our institution for a period of three years with total 49991 delivery patients . Total patients underwent bilateral internal iliac artery ligation (BIIAL ) were 29. Obstetric haemorrhage after 28 weeks pregnancy and haemorrhage refractory to medical therapy were included and obstetric haemorrhage before 28 weeks and haemorrhage due to coagulopathy were excluded. Results : Before operation all 29 BIIAL patients were haemodynamically unstable. Out of 29 patients , four of them needed another operation, among four two needed hysterectomy, two needed bilateral ovarian artery ligation, success rate was 86.2%, one patient died of irreversible shock and ARF. Bleeding arrested by BIIAL did not require later laparotomy in any woman. Conclusion : BIIAL is a valuable procedure for the treatment of PPH. It is essential for the preservation and maintainance of fertility. It can be reliably used in all cases of intractable PPH. All obstetrician should familiar themselves with this procedure and lower their threshold for its use in emergency situations.