title: Surgical control of obstetric hemorrhage: hypogastric artery ligation or hysterectomy?
abstract: Sixty-four patients with severe postpartum hemorrhage (PPH) required surgical intervention during the years 1983 to 1987. Bilateral hypogastric artery ligation (HAL) was the initial surgical approach in 45% (29/64) and hysterectomy in 55% (35/64). HAL successfully controlled hemorrhage in 65% (19/29), and failed in 35% (10/29) where hysterectomy was required as a life saving procedure. Failure of HAL was more evident in atonic PPH than in other situations. Complications were more following hysterectomy; six (6/45) patients required re-exploration for intraperitoneal hemorrhage and two (2/45) patients died following hysterectomy. HAL was found to be a relatively easy, safe and successful procedure to be attempted as an initial surgical approach for all severe PPH, specially where uterine conservation was desired.
authors.affiliation: Maternity and Children's Hospital, Riyadh, Saudi Arabia.
authors.forename: S K
authors.initials: SK
authors.lastname: Chattopadhyay
authors.forename: B
authors.initials: B
authors.lastname: Deb Roy
authors.forename: Y B
authors.initials: YB
authors.lastname: Edrees
mesh_terms: D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008026:Ligation; D008722:Methods; D006473:Postpartum Hemorrhage / Q000601:surgery*; D011247:Pregnancy