Uterine Artery Embolization Following Internal Iliac Arteries Ligation in a Case of Post-Partum Hemorrhage: A Technical Challenge

Singhal, Manphool; Gupta, Pankaj; Sikka, Pooja; Khandelwal, Niranjan

doi:10.1007/s13224-014-0595-3

Cited by 10 publications

(12 citation statements)

References 3 publications

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“…17 Nonetheless, even with these reassurances, obstetricians are posed with a challenge in considering UAE. 18 Likewise, in this study as well, the efficacy of UAE that was reported was only 32.11% which was far less than that reported in other studies. Possible reason for this low rate of success might be due to the fact that hemorrhagic patients that were included in the study were included due to anter-partum, peri-partum as well as post-partum hemorrhage.…”

Section: Figure 1: Efficacy Of Uterine Artery Ligation In Females Witcontrasting

confidence: 69%

Management of obstetric hemorrhage; an observational study highlighting the efficacy of uterine artery ligation

Ghouri

Mushtaq²,

Ahmed

et al. 2020

Int J Res Med Sci

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Background: Obstetrical hemorrhage is leading cause of maternal mortality. UAE is termed safe and effective method for resolving hemorrhage. objective of this study was to determine efficacy of uterine artery ligation in management of obstetrical hemorrhage.Methods: This cross sectional observational using non-probability convenient sampling technique was carried out for six months. After ethical approval, females between 18 to 35 years diagnosed with obstetrical hemorrhage, uterine atony refractory to medical treatment, having active bleeding from placental side or having normal coagulation profile were while females with post-partum hemorrhage because of retained products of conception, due to genital tract trauma or with disseminated intravascular coagulation were excluded. Analysis of data was done using SPSS version 23.0. Quantitative variables were reported as mean and standard deviation and for qualitative variables, frequency and percentages. Chi-square test was applied keeping p-value of <0.05 as statistically significant.Results: From 109 females with mean age 47±5.25 years. In comparison of parity distribution, 62 (56.88%) were multiparous and 47 (43.12%) were primiparous. Type of bleeding observed was antepartum 36(33.03%), peripartum 39 (35.78%) and postpartum in 34 (31.19%). Efficacy of uterine artery ligation in management of obstetric hemorrhage was observed to be 35 (32.11%). The efficacy of uterine artery ligation in management of obstetric hemorrhage in three categories of age groups reported significant association (p=0.0005) and type of bleeding (p=0.025).Conclusions: Efficacy of UAE in different types of obstetrical hemorrhage reported in our study was lower than expected in about one-third of females.

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Section: Figure 1: Efficacy Of Uterine Artery Ligation In Females Witcontrasting

confidence: 69%

Management of obstetric hemorrhage; an observational study highlighting the efficacy of uterine artery ligation

Ghouri

Mushtaq²,

Ahmed

et al. 2020

Int J Res Med Sci

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“…On the other hand, IIAL is more invasive but a life saver during the surgery. The IIAL has a success rate of 40 to 100% . Although, IIAL requires relaparatomy for the post‐partum cases it still has more advantages than UAE during surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The IIAL has a success rate of 40 to 100%. 22 Although, IIAL requires relaparatomy for the post-partum cases it still has more advantages than UAE during surgery. The major ischemic complications of the IIAL are buttock necrosis, buttock claudication and iliac vein injury.…”

Section: Discussionmentioning

confidence: 99%

Ovarian reserve after internal iliac artery ligation

Mathyk

Çetin

Atakul³

et al. 2018

J of Obstet and Gynaecol

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“…When compared with surgical ligation of the uterine or internal iliac arteries, IR techniques carry some advantages, such as being relatively unimpeded by haematomas or coagulopathies 21 . For example, following uterine trauma the avulsed uterine artery can retract into the broad ligament forming a haematoma 21 . Failure rates for surgical ligation are as high as 50%, usually associated with bleeding through collateral vessels 18 .…”

Section: Major Obstetric Haemorrhagementioning

confidence: 99%

“…Failure rates for surgical ligation are as high as 50%, usually associated with bleeding through collateral vessels 18 . In the event of extensive haematoma it may be difficult for the surgeon to identify the bleeding vessel while the interventional radiologist has the advantage of angiography 18,21,22 . However, the ability to pinpoint the offending vessel using angiography is not perfect, with a detection rate of 33–98%.…”

Section: Major Obstetric Haemorrhagementioning

confidence: 99%

The clinical applications of interventional radiological techniques in obstetrics and gynaecology

Davies

Parker

Basu

et al. 2023

The Obstetric & Gynaecologis

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Uterine artery embolisation can be used as a minimally invasive technique for the management of benign gynaecological conditions refractory to other medical treatments. The Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Radiologists (RCR) recommend the use of interventional radiology (IR) techniques for the prophylaxis and management of postpartum haemorrhage. Interventional radiologists can percutaneously drain postoperative collections or tubo-ovarian abscesses. Interventional radiology plays a role in the management of early pregnancy complications such as ectopic pregnancy and gestational trophoblastic disease. Interventional radiology can aid the care of patients with gynaecological malignancies. Learning objectivesTo understand the various IR techniques applicable to obstetrics and gynaecology To understand the risk and benefit profiles of these techniques To understand when the techniques could be appropriate and how they compare to surgical alternatives Ethical issuesThere are limited data regarding the use of some IR procedures owing to the ethical issues of using experimental techniques to treat pregnant women or women who wish to conceive. The availability of IR procedures is hospital specific so treatment is not available to all who may benefit.

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Uterine Artery Embolization Following Internal Iliac Arteries Ligation in a Case of Post-Partum Hemorrhage: A Technical Challenge

Cited by 10 publications

References 3 publications

Management of obstetric hemorrhage; an observational study highlighting the efficacy of uterine artery ligation

Management of obstetric hemorrhage; an observational study highlighting the efficacy of uterine artery ligation

Ovarian reserve after internal iliac artery ligation

The clinical applications of interventional radiological techniques in obstetrics and gynaecology

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