An advantage of bilateral
internal iliac artery ligation over obstetrical hysterectomy is the preservation of reproductive function.
Bilateral
internal iliac artery ligation is an effective lifesaving method to control obstetrical and gynaecological hemorrhage and a hysterectomy can often be avoided.
The left OBA was found to be arising from the posterior division of
internal iliac artery lying just medial to anterior division of
internal iliac artery (Fig.1).
The inferior gluteal artery is the larger terminal branch of the anterior division of
internal iliac artery and principally supplies the buttock and thigh.
Internal iliac artery ligations were done even after hysterectomy or repair of injury to the uterus as the bleeding vessel had retracted within broad ligament hematoma.
DISCUSSION: Bilateral
Internal iliac artery ligation in intractable PPH is an effective life saving method and hysterectomy can often be avoided.
In a study of 10 postpartum volunteers, application of the NASG caused decreased blood flow in the
internal iliac artery as measured by Doppler ultrasound, but blood flow did not stop completely.
A Cobra catheter was passed into the contralateral right
internal iliac artery, where digital subtraction angiography (DSA) demonstrated two areas of active contrast extravasation from the presumed internal pudendal and obturator arteries, compatible with hemorrhage secondary to traumatic lacerations (Figure 1b).
In one patient,
internal iliac artery ligation was done along with figure-of-eight sutures over placental implantation site and bilateral uterine artery ligation for PPH.
Spontaneous rupture of the
internal iliac artery in pregnancy is a rare phenomenon, and as a potentially lethal complication of pregnancy, it was first described in 1778 (1).
* Graft isthmus artery: End-to-end anastomosis to the recipient
internal iliac artery.