Effect of hypogastric artery ligation in obstetric hemorrhage and fertility

Abstract

Aim: In this study, we aimed to examine the effectiveness of hypogastric artery ligation method in obstetric hemorrhage and its effects on fertility. Patients and Methods: Sixty-two patients who underwent bilateral hypogastric artery ligation (HAL) due to obstetric bleeding at Kocaeli Derince Training and Research Hospital between November 1, 2011 and November 1, 2016 were retrospectively evaluated. Results: In patients with postpartum hemorrhage, bleeding was controlled with HAL in 47 (84%) of them, while hysterectomy was performed in addition to HAL in 9 (16%) patients. While 17 patients gave consent for bilateral tubal ligation before the operation, none were in the hysterectomy group. Postoperative follow-up information was obtained for 31 of the remaining 36 patients. It was observed that 7 of the patients had an intrauterine device inserted, 3 gave birth in our center, 18 had regular menstrual periods, and 3 had hysteroscopy due to irregular menstrual periods, which revealed no pathology. Conclusion: HAL is an important procedure used as the last step in obstetric bleeding, especially in fertility-sparing surgery, and it can be used safely by experienced surgeons. More emphasis should be placed on this surgical method in today's gynecology and obstetrics residency training process.

Keywords

• Hypogastric artery ligation
• obstetric hemorrhage
• fertility-sparing surgery

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