Uterine artery Color Doppler Parameters after Bilateral Uterine Artery Ligation for Postpartum Hemorrhage

Abstract

Introduction: Bilateral uterine artery ligation (BUAL) is the most popular surgical procedures for quick management of intrapartum hemorrhage (IPH) or postpartum hemorrhage (PPH). We established this study to evaluate the uterine artery (UtA) color doppler parameters after BUAL for PPH. Materials and Methods: This prospective cohort case control study was conducted on 70 women aged between 20 and 35 years old. Cases were classified into two equal groups, study group: cases underwent BUAL after PPH after caesarean section resistant to medical treatment and did not need to hysterectomy, control group: who underwent normal caesarean section without IPH or PPH. Follow up of doppler parameters,1st day,1 week,6 months, and 12 months of BUAL. Results: In study group, color doppler of UtA diameters as resistance Index, UtA pulsatility Index, UtA peak systolic velocity, right and left UtA end diastolic velocity, and right and left ovarian volume of both right and left sides were significantly higher after 1week, and 6 months ,12months compared to 1 day of BUAL (P value<0.001). After 24 months, there was 24 women seek to be pregnant in study group while 24 women seek to be pregnant in control group, 70.83% of women get pregnant in the study group, compared to 80% of women get pregnant in the control group. (P=0.753) Conclusion: BUAL did not impact color doppler parameters measurements after12 month of follow up, so this surgical management should be used for preserving fertility and avoid hysterectomy in women experiencing PPH.