POSTPARTUM HYPOTONIC BLEEDING. USE OF INTERNAL ILIAC ARTERY LIGATION AND UTERINE ARTERY EMBOLIZATION IN THE EARLY POSTPARTUM PERIOD


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Abstract

Objective. To comparatively evaluate the efficiency of internal iliac artery (IIA) ligation and uterine artery embolization (UAE) for hypotonic bleeding. Material and methods. Seventy-four childbirth history cases were analyzed in patients with hypotonic bleeding, who gave birth in 2002 to 2011. In 39 puerperas (Group 1), IIA ligation was performed in combination with measures to stop bleeding in the placental and postpartum periods. UAE was made in 35 patients (group 2). The two groups were comparatively analyzed; the obtained data were statistically processed by variation statistical methods using the Mann-Whitney test. Results. In all the puerperas, hysterectomy could be avoided by organ-saving surgery. After IIA ligation 56.4% of the patients additionally lost up to 300 ml of blood. After UAE, additional blood loss not exceeding 300 ml was recorded in 85.7% of the examinees. Conclusion. IIA ligation, as well as UAE, is an effective way to arrest postpartum hemorrhage. UAE should be considered to be the method of choice in promoting safe and prompt hemostasis. Vascular ligation may be undertaken if embolization is ineffective or the hospital lacks equipment.

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About the authors

M. A KURTSER

Center for Family Planning and Reproduction, Moscow Healthcare Department

Email: cfp@list.ru

I. Yu BRESLAV

Perinatal Medical Center, Moscow

Email: irina_breslav@mail.ru

Yu. Yu KUTAKOVA

Organization-and-Methodical Department of Obstetrics and Gynecology, Moscow Healthcare Department

Email: kutakova19@mail.ru

M. V LUKASHINA

Center for Family Planning and Reproduction, Moscow Healthcare Department

Email: Metodotdel@list.ru

A. V PANIN

Center for Family Planning and Reproduction, Moscow Healthcare Department

Email: Metodotdel@list.ru

B. Yu BOBROV

Center for Family Planning and Reproduction, Moscow Healthcare Department

Email: 7493149@gmail.ru

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