Wagaarachchi P T, Fernando L
Department of Obstetrics & Gynaecology, University of Kelaniya, Sri Lanka.
Hum Reprod. 2000 Jun;15(6):1311-3. doi: 10.1093/humrep/15.6.1311.
Bilateral ligation of internal iliac (hypogastric) arteries (BIL) is a life-saving operation in cases of massive obstetric haemorrhage. This operation preserves reproductive function as opposed to the more commonly performed emergency hysterectomy in such situations. We report on effectiveness and future fertility in 12 women who had internal iliac ligation to control severe obstetric haemorrhage: in 10 out of the 12 women, BIL was successful. Of the two women who subsequently needed emergency hysterectomy, one woman died of disseminated intravascular coagulation. Of the eight women we were able to follow-up to assess reproductive performance, two did not desire future fertility. Three had subsequent pregnancies (50%), of whom two proceeded to term. We conclude that BIL is a safe and effective procedure for treating life-threatening obstetric haemorrhage with preservation of future fertility. This technique should be performed more often when indicated.
双侧髂内（腹下）动脉结扎术（BIL）是治疗大量产科出血时的一种挽救生命的手术。与在这种情况下更常进行的急诊子宫切除术不同，该手术可保留生殖功能。我们报告了12例接受髂内动脉结扎术以控制严重产科出血的女性的手术效果及未来生育情况：12例女性中有10例BIL手术成功。在随后需要进行急诊子宫切除术的2名女性中，1名女性死于弥散性血管内凝血。在我们能够随访以评估生殖能力的8名女性中，2名不期望未来生育。3名女性随后怀孕（50%），其中2名足月分娩。我们得出结论，BIL是一种安全有效的治疗危及生命的产科出血并保留未来生育能力的方法。在有指征时应更频繁地实施该技术。
