scholarly journals Alternate Sequential Suture Tightening: A Novel Technique for Uncontrolled Postpartum Hemorrhage

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Sharda Brata Ghosh ◽  
Y. M. Mala
Keyword(s):  
Postpartum Haemorrhage ◽  
Internal Iliac Artery ◽  
Successful Outcome ◽  
Artery Ligation ◽  
Novel Technique ◽  
Long Term Follow Up ◽  
Internal Iliac ◽  
Fertility Potential

Objective. The most commonly described technique of modified B-Lynch suture may not be suitable for all the patients presenting with flabby, atonic uterus.Study Design. A retrospective analysis of twelve patients with uncontrolled postpartum haemorrhage, who underwent this procedure from March 2007 to September 2012, was conducted. In this novel technique, sutures are passed in the lower uterine segment and are tightened alternately to control uterine bleeding.Results. Average duration of the procedure was 4 minutes (range 2–7 minutes). Average blood loss was 1625 mL (range 1300–1900 mL). Eleven patients (91.66%) were seen to have a successful outcome with only this technique. No patient required hysterectomy and one patient (8.33%) required additional bilateral internal iliac artery ligation. All the patients had a minimum follow-up of 2 yrs and none of them reported any infertility problems.Conclusion. This technique is simple, quick, and effective. There was no adverse effect on the fertility potential for the observed 2 years; however, a long-term follow-up is required to comment on its actual rate. This technique cannot replace the standard modified B-Lynch technique for uncontrolled postpartum haemorrhage but can be used for unresponsive, flabby, and atonic uterus.

scholarly journals Internal Iliac Artery Embolization for the Control of Severe Bladder Hemorrhage Secondary to Carcinoma: Long-Term Follow-Up

2007 ◽  
Vol 7 ◽  
pp. 1567-1574 ◽  
Author(s):  
Ahmed El-Assmy ◽  
Tarek Mohsen
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Arterial Embolization ◽  
Artery Embolization ◽  
Severe Hemorrhage ◽  
Long Term Follow Up ◽  
Internal Iliac ◽  
Internal Iliac Artery Embolization

The purpose of this study was to evaluate the efficacy and long-term complications of internal iliac artery embolization as a palliative measure in the control of intractable hemorrhage from advanced bladder malignancy. From January 1998 through December 2005, seven patients underwent transcatheter arterial embolization (TAE) of anterior division of internal iliac artery bilaterally for intractable bladder hemorrhage. After embolization, patients were followed for the efficacy of the procedure in controlling hematuria and complications. TAE was successful in immediate control of severe hemorrhage in all seven patients after a mean period of 4 days. At a mean (range) follow-up of 10 (6–12) months, the hemorrhage was permanently controlled in four (57%) patients. Three patients developed hematuria and required emergency admissions; two had mild hematuria and were managed conservatively, and the remaining one required a second attempt of embolization after 2 months from the first one. During the whole period of follow-up, there were no significant complications related to embolization. Internal iliac artery embolization is an effective and minimally invasive option when managing advanced bladder malignancies presenting with intractable bleeding. The long-term follow-up showed control of bleeding in the majority of such patients with no serious complications.

PROPHYLACTIC BILATERAL INTERNAL ILIAC ARTERY LIGATION, IN PREVENTION OF PPH, IN A CASE OF MULTIPLE LARGE INTRA MURAL FIBROIDS

2021 ◽  
pp. 83-84
Author(s):  
Aditi Gaiwal ◽  
Devdatta Dabholkar
Keyword(s):  
Blood Loss ◽  
Clinical Diagnosis ◽  
Iliac Artery ◽  
Postpartum Haemorrhage ◽  
Internal Iliac Artery ◽  
Artery Ligation ◽  
Internal Iliac Artery Ligation ◽  
Internal Iliac ◽  
Excessive Blood Loss

Postpartum haemorrhage is dened as a blood loss of more than 500ml after delivery of the placenta. It is a clinical diagnosis that encompasses excessive blood loss after delivery of the baby from a variety of sites: uterus, cervix, 1 vagina and perineum

scholarly journals Endovascular treatment of intractable epistaxis - results of a 4-year local audit

2004 ◽  
Vol 8 (3) ◽  
pp. 9 ◽  
Author(s):  
Ian C Duncan ◽  
P.A. Fourie ◽  
C.E. Le Grange ◽  
H.A. Van der Walt
Keyword(s):  
Success Rate ◽  
Morbidity Rate ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Artery Ligation ◽  
Endovascular Embolisation ◽  
Long Term Follow Up ◽  
Initial Procedure ◽  
Intractable Epistaxis

A total of 57 endovascular embolisation procedures were performed for intractable epistaxis in 51 patients over a 4-year period at the Unitas Interventional Unit near Pretoria. Long-term follow-up was possible in 36 patients. Three cases were due to trauma and 2 directly related to previous facial surgery, 1 patient had hereditary haemorrhagic telangiectasia (HHT), and the remaining 45 cases (88.2%) were classed as idiopathic. Eight patients (15.7%) had a rebleed between 1 and 33 days after the initial embolisation. Four were re-embolised once, 1 was re-embolised twice (the HHT patient), and 2 underwent additional ethmoid artery ligation (with no further bleeding). This gives a primary short-term success rate (in all 51 cases) of 86.3% and a secondary assisted success rate of 94.1% for embolisation alone. Long-term follow- up was obtained in 36 patients, with 35 (97.2%) reporting no further bleeding after the initial procedure(s). Only the patient with HHT developed multiple recurrent bleeds. The mortality rate was 0%, the major morbidity rate 2% (1 stroke), and the minor morbidity rate 25% (N = 36), which included transient facial pain, headaches and femoral problems related to access. Our results compare favourably with other published series. In conclusion, endovascular embolisation for intractable epistaxis is available locally as an alternative technique for the treatment

How B-Lynch suture and bilateral internal iliac artery ligation saved the uterus of a young patient with severe postpartum haemorrhage

2021 ◽  
Vol 14 (8) ◽  
pp. e244226
Author(s):  
San San Win ◽  
Helen Benedict Lasimbang ◽  
Sai Nay Lynn AUng ◽  
Tat Boon Yeap
Keyword(s):  
Young Patient ◽  
Iliac Artery ◽  
Postpartum Haemorrhage ◽  
Internal Iliac Artery ◽  
Artery Ligation ◽  
Internal Iliac Artery Ligation ◽  
Obstetric Haemorrhage ◽  
Future Fertility ◽  
Obstetric Emergencies ◽  
Internal Iliac

Obstetric haemorrhage is the leading cause of maternal death worldwide (27.1%) and more than 66% of its deaths were classified as postpartum haemorrhage (PPH). The most common cause of PPH is uterine atony. Obstetrician should be skillful in managing obstetric emergencies; especially pertaining to PPH. Application of the B-Lynch suture on an atonic uterus is one of the surgical options in PPH patients who wish to conserve the uterus and it has a very high success rate.We present a primigravida patient who developed massive primary PPH followed by disseminated intravascular coagulation, which was successfully managed with B-Lynch suture and bilateral internal iliac artery ligation. We described in detail regarding the management of massive PPH and application of these surgical procedures on the atonic uterus with an attempt to preserve the uterus and future fertility in this young patient.

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