Obstetrical Prognosis following ligation of Hypogastric arteries

Authors

  • Nabil Mathlouthi
  • Belhassen Ben Ayed
  • Mohamed Dhouib
  • Kaies Chaabene
  • Khaled Trabelsi
  • Mohamed Ayadia
  • Kamel Kolsi
  • Habib Amouri
  • Mohamed Guermazi

Keywords:

Post partum hemorrhage-hypogastric artery ligation-fertility.

Abstract

Background: Ligation of hypogastric arteries is a conservative surgical treatment in cases of postpartum hemorrhage.
Aim: To study the fertility and pregnancies outcome in women who required hypogastric artery ligation for severe post-partum haemorrhage in our hospital.
Methods: The fertility and pregnancy outcome parameters were retrieved from medical files and telephone interviews
Results: 34 patients required hypogastric ligation on this period. 39 pregnancies were observed with 30 term deliveries, 1 ectopic pregnancies and 8 miscarriages. Two patients had infertility and pregnancy was obtained in less than 10 months most once desired.Pregnancy outcome was normal. 73,3% of deliveries were by
caesarean.
Conclusion: Hypogastric artery ligation for post-partum haemorrhage is not responsible for secondary infertility. Following pregnancies do not suffer complications from the ligation.

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References

Barrinque L, Nizard J, Frydman R, Fernandez H. Grossesses après ligature des artères hypogastriques pour hémorragie du post partum. Rev sage fem 2002; 3 :137-42.

Nelson RM. Bilateral internal iliac artery ligation in cervical pregnancy: conservation of reproductive function. Am J Obstet Gynecol 1979; 134:145-50.

Wolcott HD, Kaunitz AM, Nuss RC, Benrubi GE. Successful pregnancy after previous conservative treatment of an advanced cervical pregnancy. Obstet Gynecol 1988;71: 1023-5.

Papp L, Sztanyik L, Szabo I, Inovay J. Successful pregnancy after bilateral internal iliac artery ligation monitored by color Doppler imaging. Ultrasound Obstet Gynecol 1996; 7:211-2.

Wagaarachi PT, Fernando L. Fertility following ligation of internal iliac arteries for life-threatening obstetric haemorrhage: case report. Hum Reprod 2000; 15: 1311-3.

SieunarineK, Moxey P, Boyle DC et al. Selective vessel ligation in pelvis: an unvaluable tool in certain surgical procedures. Int J Gynecol Cancer 2005; 15: 967-73.

Ungar L, Palfalvi L, Hogg R et al. Abdominal radical trachelectomy: a fertility preserving option for women with early cervical cancer. BJOG 2005; 112:366-9

Mayer HG. Collateral circulation in the small pelvis after ligation of both internal iliac arteries. J Obstet Gynecol 1975; 97:688-91.

Sziller I, Hupuczi P, Papp Z. Hypogastric artery ligation for severe hemorrhage in obstetric patients. J Perinat Med 2007; 35: 187-92.

Khelifi A, Amamou K, Salem Aet al. therapeutic ligature of hypogastric arteries: color Doppler follow -up. J Radiol 2000; 81:607-10.

CHitrit Y, Guillaumin P, Caubel P, Herrero H. Absence of flow velocity waveform changes in uterine arteries after bilateral internal iliac artery ligation. Am J Obstet Gynecol 2000; 182: 727-8.

Demicri F, Ozdemir I, Safak A et al. Comparison of color Doppler indices of pelvic arteries in women with bilateral hypogastric artery ligation and controls. J Obstet Gynecol 2005; 25:273-4.

Yildirim Y, Gultekin E, Kocyigit A et al. Color Doppler analysis of pelvic arteries following bilateral internal iliac artery ligation for severe postpartum hemorrhage. Int J Gynecol Obstet 2009; 104: 22-24.

D. Chelli, F.Boudaya, K.Dimassi et al. Ligature bilatérale des artères hypogastriques dans la prise en charge de l'hémorragie du post partum. J Gynecol Obstet Biol Reprod 2010; 39 :43-49.

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Published

2011-10-28

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Original articles