Bilateral Internal Iliac Artery Ligation and Its Role in Reducing Maternal Mortality

Article Type: Original Article
Authors: Tanya Sanjay Vijan, Sameer Kadam, Sushil Kumar


Background: Postpartum hemorrhage (PPH) is a common complication leading to maternal mortality worldwide. When medical methods fail to restore the uterine tone, the traditional surgical method is emergency obstetric hysterectomy. Bilateral internal iliac artery ligation (IIAL) serves as an alternative approach to the surgical control of obstetric hemorrhage and conservation of fertility.Aim: To assess the role of bilateral IIAL in reducing maternal mortality rate (MMR).Material and methods: A retrospective study, of a standardized procedure performed for 30 cases over a period of 10 years (2013–2022) at MGM Women’s Hospital, Kalamboli, Navi Mumbai was reviewed and surgical outcome and complications of procedure was also noted. The maternal mortality data over past 2 decades was compared and MMR amounting to PPH, PAS and uterine rupture, the three most significant indications for bilateral IIAL, reduced from 150 to 49.2 per 100,000 live births.Results: The effectiveness of B/L IIAL to circumvent hysterectomy in PPH is up to 88% of cases.Conclusion: IIAL is a safe and effective method to control massive pelvic hemorrhage in experienced hands and is the method of choice to preserve and maintain the fertile state of the patient.

Keywords: Postpartum hemorrhage, internal iliac artery ligation, maternal mortality, obstetric hysterectomy.
Issue Number: Issue - 3   September - December 2022
Pages: 97 - 138
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