Combined utero ovarian artery ligation (Quadruple ligation) was done in one patient, and two patients responded to bilateral internal iliac artery ligation (BIIL) or hypogastric artery
To maintain sufficient circulation and tissue oxygen supply in PPH, and to stop the hemorrhage simultaneously, interventions such as uterotonic agents, use of Bakri balloon tamponade, B-lynch suture, uterine artery or hypogastric artery
ligation, uterine artery embolization, and when necessary, hysterectomy in addition to general obstetric procedures are life-saving (3,4).
The elusive isolated hypogastric artery
aneurysm: novel presentations.
(b) Selected right hypogastric artery
showing uterine branch (arrowhead) leading to faint oval blush of pseudoaneurysm (chevron).
However, if these manoeuvres fail, a number of surgical techniques, such as uterine artery ligation, hypogastric artery
ligation and uterine compression sutures have been described.
Accidental hypogastric artery
coverage occurred in 2 patients of group A, but not in group B (6.7% vs.
Although bilateral hypogastric artery
ligation was planned, it could not be performed because of active bleeding.
In the former, uterine artery embolization is used, whereas surgical approaches involve bilateral uterine artery ligation and bilateral hypogastric artery
ligation procedures .
Methods: This cross-sectional controlled study was conducted at Batman Gynaecology and Paediatric Diseases Hospital, Batman, Turkey, between June 15 and July 23, 2015, and comprised cases of patients with peripartum hysterectomy and of those who had experienced surgical procedures other than hysterectomy (hypogastric artery
ligation and/or B-Lynch suture).
embolization in endovascular abdominal aortic aneurysm repair.
Yet, owing to the activation of the anastomotic network immediately after ligation, blood is never completely drained from the hypogastric artery
distally to the site of ligation as demonstrated by Burchell in 1968 .
((d) and (e)) Left and right postembolization hypogastric artery
angiography, respectively: complete occlusion of the uterine arteries after Onyx-18 injection and preservation of the other hypogastric branches; the Onyx-18 cast is indicated by the black arrows.