Prophylactic internal iliac artery ligation in case of postpartum hemorrhage due rupture uturus [randomized controlled study]

ABSTRACT

To evaluate the role of internal iliac artery ligation as an effective method of controlling post partum hemorrhage due to lateral uterine rupture. A randomized controlled study was conducted on 50 pregnant women who were admitted to Shatby University Maternity Hospital between June 2006 and Au gust 2008, all of them were diagnosed as post partum hemorrhage due to lateral uterine rupture. The patients were randomly allocated to 2 groups, the ligation group where ligation of internal iliac artery followed by repair of ruptured uterine wall was done [group A], and the repair group, where ruptured uterus was repaired by conventional methods [group B]. informed consent was taken from all patients. The ligation group showed a significant statistical difference when compared with the repair group regarding inn-a-operative time; amount of blood transfused intro-operatively; duration of intensive care unit stay, need for additional surgical interference such as hysterectomy or additional vaginal haemostasis, and the incidence of complications as disseminated intravascular coagulopathy, and ureteric injury. Internal iliac artery ligation is considered an alternative effective method to hysterectomy in cases of lateral uterine rupture, aiming to decrease maternal morbidity