The value of internal iliac artery ligation (IIAL) in a sample of Iraqi women with post-partum haemorrhage

Abstract

Severe pelvic bleeding is an anticipated life-threatening complication in the field of obstetrics and gynaecological surgical practice. One effective strategy is via ligation of the internal iliac artery (IIAL). The current study aimed at evaluating the success rate of IIAL in a sample of Iraqi women with postpartum haemorrhage. The present observational cohort study included 50 women with postpartum haemorrhage. Women aged from 35 to 45 years. The study was conducted at the gynaecology department, Al-Diwaniyah maternity and child teaching hospital, Al-Diwaniyah province, Iraq. The study started on January 2017 and ended in January 2018. An attempt of internal artery ligation was performed in all cases to control the bleeding, and the outcome was classified into one of three major groups. The first group in which control of bleeding was successful, the second group included women who ended up with hysterectomy and the third group included those unfortunate women that arrive late and died before bleeding was efficiently controlled. The mean age of women enrolled in the present study was 37.11±5.19 years. The study included 50 women with postpartum haemorrhage, 30 of them (60%an) ended with preservation of uterus, 18 (36.0%) ended with hysterectomy, and 2 of them (4.0%) died because of late arrival and inability to control the severe bleeding with consequent shock, and death. Indications of IIAL were as following: atonic postpartum haemorrhage in 22 cases (44.0%), traumatic postpartum haemorrhage in 8 cases (16.0%) and placenta previa in 20 cases (40.0%). IIAL appears to be the rapid, safe and life-saving procedure to minimize mortality and morbidity in women suffering from postpartum bleeding; also, it plays a significant role to avoid unnecessary hysterectomy.