Pelvic arterial ligations for severe post-partum hemorrhage. Indications and techniques

Morel, Olivier; Malartic, C.; Muhlstein, J.; Gayat, Étienne; Judlin, P; Soyer, Philippe; Barranger, Emmanuel

doi:10.1016/j.jviscsurg.2011.02.002

Cited by 34 publications

(27 citation statements)

References 27 publications

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“…Surgical arterial ligation, uterine compression suture, TAE, or hemostatic hysterectomy can be used depending on the clinical presentation [5,[51][52][53]. Surgery is preferred when uterine rupture or bladder injuries are suspected [5,52].…”

Section: Surgical and Interventional Radiological Managementmentioning

confidence: 99%

“…In developed countries, the frequency of emergency peripartum hysterectomy was around 1/1,000 deliveries in 1990 and dropped to 1/2,000 deliveries in 2010 [3]. This substantial drop is presumably due to early identification of PPH with appropriate initial measures, marked improvements in medical resuscitation, and an increased use of conservative treatments including pelvic artery ligation, uterine compression sutures, balloon tamponade, and percutaneous transcatheter arterial embolization (TAE) [4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications

Soyer

Dohan

Dautry

et al. 2015

Cardiovasc Intervent Radiol

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Postpartum hemorrhage (PPH) is a potentially life-threatening condition, which needs multidisciplinary management. Uterine atony represents up to 80 % of all causes of PPH. Transcatheter arterial embolization (TAE) has now a well-established role in the management of severe PPH. TAE allows stopping the bleeding in 90 % of women with severe PHH, obviating surgery. Pledgets of gelatin sponge as torpedoes are commonly used for safe TAE, and coils, glue, and microspheres have been primarily used in specific situations such as arterial rupture, pseudoaneurysm, and arteriovenous fistula. TAE is a minimally invasive procedure with a low rate of complications, which preserves future fertility. Knowledge of causes of PPH, potential risks, and limitations of TAE is essential for a timely decision, optimizing TAE, preventing irreversible complications, avoiding hysterectomy, and ultimately preserving fertility.

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Section: Surgical and Interventional Radiological Managementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications

Soyer

Dohan

Dautry

et al. 2015

Cardiovasc Intervent Radiol

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“…In this study, HAL was performed to avoid maternal death in the cases of intractable obstetrical hemorrhage with uterine atony or placental abnormalities. As summarized in a recent review by Morel et al (8), HAL requires an adequate surgical exposure of the lower abdomen. In most cases, the abdominal incision of a cesarean section is suitable for this procedure.…”

Section: Discussionmentioning

confidence: 99%

Hypogastric artery ligation for obstetrical hemorrhage: clinical experiencein a tertiary care center

Yıldız¹,

Akkar²,

Karakuş³

et al. 2015

Turk J Med Sci

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Background/aim: Several authorities advocate the use of hypogastric artery ligation (HAL) in the treatment of cases of obstetrical hemorrhage related to uterine atony or placenta accreta. We assessed the morbidity and mortality of patients who underwent HAL as a component of emergency procedures to control life-threatening uterine bleeding in a tertiary-care university hospital. Materials and methods:In this retrospective study, the clinical data of 24 eligible patients who underwent HAL between 2010 and 2013 in a university hospital to prevent or control severe uterine bleeding were collected and analyzed with regard to intraoperative and postoperative findings.Results: In the study population, there were nine patients with uterine atony managed without hysterectomy after HAL and there were 15 patients with placenta previa complicated with placenta accreta after HAL. Of these 15 patients, seven underwent hysterectomy and eight were managed without hysterectomy. Overall, the clinical features of the patients managed with or without hysterectomy were similar for patients with uterine atony and placenta previa. Conclusion:We suggest that if HAL is performed in a surgical setting as mentioned in this study, it may be a life-saving and fertilitysparing procedure.

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“…An absorbable suture is placed 2 cm below the bladder reflection on both sides of the uterus avoiding the ureters. This technique occludes the ascending branch of uterine vessels, with reported success rate of 80-96% (Morel et al, 2011). This procedure is technically safe other than possible risk of ureteric injury.…”

Section: Bilateral Uterine Artery Ligationmentioning

confidence: 96%

“…It requires a good knowledge of anatomy to avoid inadvertent injuries to the external iliac vessels and ureters. The success rate of internal iliac artery ligation varies between 42-93% (Morel et al, 2011). Incorrect ligation entails high risks of limbs ischaemia, gluteal claudication, further bleeding and possible ureteric and nerve injury.…”

Section: Bilateral Internal Iliac (Hypogastric Artery) Ligationmentioning

confidence: 99%

Uterine Atony: Management Strategies

Lim¹,

Shafiee²,

Kampan³

et al. 2012

Blood Transfusion in Clinical Practice

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Pelvic arterial ligations for severe post-partum hemorrhage. Indications and techniques

Cited by 34 publications

References 27 publications

Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications

Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications

Hypogastric artery ligation for obstetrical hemorrhage: clinical experiencein a tertiary care center

Uterine Atony: Management Strategies

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