title: Hypogastric artery ligation for obstetrical hemorrhage: clinical experience in a tertiary care center.
abstract: OBJECTIVE
  Several authorities advocate the use of hypogastric artery ligation (HAL) in the treatment of cases of obstetrical hemorrhage related to uterine atony or placenta accreta. We assessed the morbidity and mortality of patients who underwent HAL as a component of emergency procedures to control life-threatening uterine bleeding in a tertiary-care university hospital.
  
  
  METHODS
  In this retrospective study, the clinical data of 24 eligible patients who underwent HAL between 2010 and 2013 in a university hospital to prevent or control severe uterine bleeding were collected and analyzed with regard to intraoperative and postoperative findings.
  
  
  RESULTS
  In the study population, there were nine patients with uterine atony managed without hysterectomy after HAL and there were 15 patients with placenta previa complicated with placenta accreta after HAL. Of these 15 patients, seven underwent hysterectomy and eight were managed without hysterectomy. Overall, the clinical features of the patients managed with or without hysterectomy were similar for patients with uterine atony and placenta previa.
  
  
  CONCLUSIONS
  We suggest that if HAL is performed in a surgical setting as mentioned in this study, it may be a life-saving and fertility-sparing procedure.
authors.forename: Cağlar
authors.initials: C
authors.lastname: Yildiz
authors.forename: Ozlem Bozoklu
authors.initials: OB
authors.lastname: Akkar
authors.forename: Savaş
authors.initials: S
authors.lastname: Karakuş
authors.forename: Ali
authors.initials: A
authors.lastname: Cetin
authors.forename: Ali
authors.initials: A
authors.lastname: Yanik
mesh_terms: D000328:Adult; D001158:Arteries / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008026:Ligation; D010921:Placenta Accreta / Q000601:surgery; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014593:Uterine Inertia / Q000601:surgery; D055815:Young Adult