Key result
Emergency internal iliac artery ligation linked to ~36% higher blood transfusion need versus elective procedures.
Why the study?
The role and efficacy of internal iliac artery ligation in obstetrics and gynaecology practice required further study.
Does internal iliac artery ligation improve control of pelvic haemorrhage and prevent unnecessary hysterectomy in women with obstetrical and gynaecological indications?
Observational (n=89)
No
Does internal iliac artery ligation improve control of pelvic haemorrhage and prevent unnecessary hysterectomy in women with obstetrical and gynaecological indications?
Absolute Event Rate: 100% vs 73.3%
p-value: p=0.0003
Internal iliac artery ligation is a safe and effective method for controlling pelvic hemorrhage and preserving the uterus in obstetrical and gynecological emergencies.
Anticipate higher transfusion needs in emergencies; observational data leave open ligation's role in uterine preservation.
Objective: To study the role and efficacy of internal iliac artery ligation (IIAL) in obstetrics and gynaecology practice.Methods: Retrospective review of detailed clinical data of 89 women who underwent emergency or elective IIAL from January 2009 to December 2019 for any obstetrical or gynaecological indication at Shri Guru Ram Rai Institute of medical and health sciences, Dehradun, Uttarakhand.Results: Among 89 cases, 76 were done for obstetrical and 13 for gynaecological indication.Morbidly adherent placenta and uterine atony were the main indications for IIAL in obstetrics while radical hysterectomy in gynaecological cases.Our study shows a statistically significant (P value <0.005) correlation in the need for blood transfusion between elective versus emergency IIAL.Among 76 cases done for obstetrical indication, in 65.8% of cases uterus was saved emphasizing the importance of IIAL.Conclusion: IIAL is a safe, rapid and effective method of controlling pelvic haemorrhage during any emergency or elective pelvic surgery and it also prevents unnecessary hysterectomy in many obstetrical indications.
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Gupta et al. (2022) conducted an observational in Pelvic haemorrhage in obstetrics and gynaecology (n=89). Emergency Internal iliac artery ligation (IIAL) vs. Elective Internal iliac artery ligation (IIAL) was evaluated on Need for blood transfusion in obstetrical cases (p=0.0003). Emergency internal iliac artery ligation in obstetrical cases was associated with a significantly higher need for blood transfusion compared to elective procedures (100% vs 73.3%, p=0.0003), while achieving an overall uterine salvage rate of 65.8%.
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