Internal iliac artery ligation: a life saving procedure

Abstract

17 cases in which one or both internal iliac artery ligations were performed over a period of 3 yr were studied for the effectiveness and the eventual outcome of this procedure. In 15 cases the indications were for therapeutic control of massive hemorrhage in various gynecologic and obstetric conditions. Two cases were for teaching purposes. This method of arterial ligation offered satisfactory results. Hemorrhages were effectively controlled in all but one in whom additional vaginal packing was required to overcome the oozing. In a few cases the hemorrhage may not be completely arrested, but iliac artery ligation certainly reduced and controlled excessive loss. The indications and complications were presented and discussed. There were no serious post operative complications that could be directly attributed to this procedure. Any radical surgery and other prevailing inherent factors in each individual patient played an important role in the incidence of complications. The author concludes there should be less reluctance to resort to this operation when other methods of arresting the hemorrhage have failed. There is certainly a place for this type of operation in obstetrical practice. It reduced avoidable maternal mortality from massive hemorrhage and the uterus and its reproductive function were preserved. The author recommends that responsible obstetricians and gynecologists should be familiar with this life saving procedure, and all residents in training should be taught the technique.