This study outlines a protocol for evaluating hemostasis and collateral circulation via pelvic angiography following hypogastric artery ligation in obstetric and gynecologic surgeries.
Should not yet change ligation protocols; hypothesis-generating for angiography-based hemostasis assessment in obstetric hemorrhage.
This study was conducted at the Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Bombay. An analysis was made of the hypogastric artery ligations done at our institution from January 1985 to December 1990. A prospective pilot study beginning June 1989 was added to the existing data. The hemostasis achieved intraoperatively and the collateral circulation maintained after main trunk ligation vs selective anterior division ligation have been studied prospectively with pelvic angiography postoperatively. Pelvic angiography using the standard Seldinger technique was done 14 days posthypogastric artery ligation in emergency obstetric cases. In selected gynecologic cases posted for Wertheim's hysterectomy, pelvic angiography was done both before and after hypogastric artery ligation. All the collected data, including operative time, blood loss, and complications, have been tabulated and compared with other studies in the literature.
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Gautam Allahbadia (1993) studied this question.
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