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Role of Internal Iliac Artery Ligation in Severe Obstetric Haemorrhage: Still Alive Original Article
Author(s) Name:
Rubaba Abid, Attiya Begum, Rubina Irfan , Fehmida Shaheen
Address of Correspondence
Dr. Rubaba Abid, Assistant Professor, Dept. of Obs & Gynae, Holy Family Hospital, Rawalpindi

Objective: To study the efficacy and outcome of bilateral internal iliac artery ligation in obstetric cases.
Study Design: Retrospective observational study.
Place & Duration of study: Dept. of Obs/Gynae unit II Holy Family Hospital. Rawalpindi from January 2012 to December 2014.
Methodology:  Women admitted to HFH who underwent BIAL to control or prevent haemorrhage.
Main outcome measures were
1).    Any complication of the procedure.         2)     The need for re-laparotomy.
In this study we analyzed 12 cases of BIAL which was done to control excessive pelvic and post partum haemorrhage.
Results: During this period we had 18,291 deliveries in our unit. Bilateral internal iliac  artery ligation was performed on 12 patients. It was done in 5 (41.6%) for primary PPH, 2 (16%) for secondary PPH, 2 (16%) for uterine rupture, 2 (16%) for post hysterectomy referral to tertiary care hospital for intraperitoneal bleed,
1(8.3%) for broad ligament haematoma and persistent shock after caesarean section in rural settings. Haemostasis was secured in all patients, however 2(16%) died due to complications e.g. septicemia, DIC and multiorgan failure. Hysterectomy was done in 7(58.3%) patients. Uterus was conserved in 5(41.6%) patients. No complication regarding procedure of BIAL was observed. 
Conclusion: BIAL is a life saving procedure along with being a fertility sparing method especially in low resource countries.
Keywords: Bilateral internal iliac artery ligation (BIAL), Pelvic hemorrhage.

Cite this article as: Abid R, Begum A. Irfan R, Shaheen F. Role of Internal Iliac Artery Ligation in Severe Obstetric Haemorrhage: Still Alive . J. Soc. Obstet. Gynaecol. Pak. 2016; Vol 6(1):12-16.

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