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Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
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2015, Number 01

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Ginecol Obstet Mex 2015; 83 (01)

Hypogastric arteries ligation: an experience in gynecological and obstetric patients at Hospital Universitario de Saltillo

García TJI, Delgado-Rosas A, González-Cantú G
Full text How to cite this article

Language: Spanish
References: 10
Page: 32-40
PDF size: 653.95 Kb.


Key words:

Pelvic hemorrhage, ligation, hypogastric artery, pelvic surgery.

ABSTRACT

Background: Pelvic hemorrhage is a potential complication that occurs performing an obstetric or gynecological surgery, it is essential to know the distribution of pelvic vascular supplement, and implement preventive measures, can significantly reduce morbidity and mortality.
Objective: To describe the experience of hypogastric artery ligation, as a preventive and therapeutic measure of pelvic hemorrhage, this will give us new prospective lines for future investigation.
Methods: Retrospective observational study, in which all patient who were performed a surgical procedure and report hypogastric artery ligation at the Saltillo University Hospital, from January 2008 to July 2014 was studied.
Results: 41 patients were obtained with hypogastric artery ligation, 28 gynecological and 13 obstetric patients. Among gynecological indications, cancer surgery represents 67.85%, benign lesions 25% and pelvic abscess 7.12%. Obstetric indications were uterine hypotonia with 46%, placenta previa with 23.07% and uterine fibroids, broad ligament hematoma and abruptio placenta a total of 30.7%. There was one complication in relation with technique that was a laceration of internal iliac artery without any consequence linked to this. And uterine preserving of 62% was observed in obstetric patients.
Conclusions: This technique is a feasible and safe for preventive and therapeutic management of pelvic surgery, with a low incidence of complications 3.5% in gynecological patients and 0% in obstetric, with a mortality of 0%.


REFERENCES

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  2. García-López A, Martínez-Aguirre R, Hernández-Romero F, Naranjo-Gutiérrez A, Montes-Reyes J. Ligadura de arterias hipogástricas. Seguridad y eficacia de un programa de adiestramiento. Ginecol Obstet Mex 2001;69:443-448.

  3. Bellad MD. Internal Iliac Artery Ligation (IIAL): An uterus/ Life saving procedure. South Asian Federation of Obstetrics and Gynecology 2009;1:32-33.

  4. Dastur AE, Tank PD, Howard AK. Much beyond the stitch. J Obstet Gynecol India 2010;60:392-394.

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  6. Serrano-Berrones MA. Comparación de dos técnicas quirúrgicas conservadoras para el tratamiento de la hemorragia obstétrica. RevEspMedQuir 2013;18:100-107.

  7. Ghanorro EP, Abedi HO, Isiavwe JO. Prophylactic internal iliac artery ligation in pelvic surgery. International Journal of Gynecology & Obstetrics 1999;65:307-309.

  8. Alemán-Ramirez PE, Suárez-González JA, Medina-Escobar E, Iglesias-Yera A. Ligadura de las arterias hipogástricas: una decisión oportuna en el sangrado de causa obstétrica. Medicentro 2005;9:1-6.

  9. McDonough PG, Emich JP, Schwarz RH. Interval before appearence of colaterals following hypogastric ligation. JACOG 1965;25:213-216.

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Ginecol Obstet Mex. 2015;83