Ligation of a hypogastric artery in the management of placenta Previa and accrete

Abstract

Placenta previa and accreta are a high-risk condition causing high morbidity and mortality in obstetrics and may end with hysterectomy and blood transfusion. The current study was aimed to observe the benefit of ligation of bilateral internal iliac arteries [hypogastric arteries] in diagnosed cases of placenta accrete and previa and decreased rate of hysterectomy and blood transfusion in this cases. The present observational cohort study includes 50 pregnant women with placenta previa or placenta accreta with the previous history of cesarean sections. The study was conducted at the Gynecology Department, Al-Diwaniyah maternity and child teaching hospital, Al-Diwaniyah province, Iraq. All available cases during the period of study were undergone to internal iliac artery ligation after delivery of the fetus and before removal of the placenta, then the placenta was removed by the piecemeal manner and then hemostatic sutures to the site of the placenta to control bleeding was done. The results revealed the ligation of bilateral internal iliac artery in patients with placenta accreta and increase the rate of hysterectomy decrease and the need for blood transfusion also decreased. When we do bilateral internal iliac artery ligation in placenta, accrete we find it is an effective technique to reduce complications and decrease the rate of hysterectomy. While in cases of placenta previa accreta, ligation of the internal iliac artery did not become effective, and the main cases with placenta previa accreta end with hysterectomy.