[Vascular ligation for severe obstetrical hemorrhage: review of the literature].
OBJECTIVE
Assess the contribution of vascular ligation in the treatment of severe obstetrical hemorrhage. Method. We reviewed the anatomic and pathophysiological basis of vascular ligation analyzing the technique, results, and indications for this conservative procedure for the severe post-partum hemorrhage. New developments in suture techniques for uterine bleeding are under study.


RESULTS
Outcome after uterine artery ligation is good. A stepwise procedure with progressive ligation of the uterine and ovarian arteries is a good solution (100% success). Bilateral ligation of the hypogastrics can provide success in 66% of cases. Vascular ligation can be an alternative between embolization and hysterectomy.


CONCLUSIONS
Ligation of the bleeding vessels preserves the patient's life and uterus. More than fifty pregnancies have been reported after vascular ligation.
Salvat
J
J
Service de Gynécologie, Oncologie et Mammaire, Hôpitau de Léman, site G Pianta, 74203 Thonon.
Schmidt
M H
MH
Guilbert
M
M
Martino
A
A
D001158:Arteries / Q000601:surgery; D004621:Embolization, Therapeutic; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007044:Hysterectomy; D007083:Iliac Artery / Q000033:anatomy & histology / Q000601:surgery; D008026:Ligation / Q000379:methods; D010053:Ovary / Q000098:blood supply; D010343:Patient Admission / Q000706:statistics & numerical data; D018579:Patient Selection; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012720:Severity of Illness Index; D013536:Suture Techniques; D016896:Treatment Outcome; D014599:Uterus / Q000098:blood supply