Department of Obstetrics and Gynecology, Provincional Hospital in Przemysl, ul. Monte Cassino 18, Przemysl, Poland.
Climacteric. 2011 Feb;14(1):54-7. doi: 10.3109/13697130903548916. Epub 2010 Feb 3.
Internal iliac artery ligation is one of the treatment methods used for obstetric hemorrhage. The long-term effects of that intervention on ovarian function remain unknown. The objective of the study was to evaluate the effect of iliac artery ligation on ovarian blood supply and ovarian reserve.
Six patients who had undergone internal iliac artery ligation were recruited as the study group. Six women of the same age, parity and time after delivery who had not undergone the internal iliac artery ligation procedure served as the control group. Quantitative digital angiography and angio-CT of the ovarian arteries and the ovarian branches of the uterine arteries were carried out from 6 to 26 months after the operation. Blood samples were taken on the 3rd day of the menstrual cycle for subsequent hormone analysis of follicle stimulating hormone (FSH) and anti-Müllerian hormone (AMH).
Following angio-CT, in the study group, reversed blood flow in the ovarian branches of the uterine arteries was observed: contrast medium flowed from the ovarian arteries towards the ovaries and from the ovarian branches of the uterine arteries to the uterine arteries. In the control group, there was no contrast medium flow from the ovaries towards the ovarian branches of the uterine arteries. Quantitative digital angiography of the ovarian arteries showed that, in the study group, the mean ovarian artery diameter was significantly dilated (p < 0.05). In the study group, AMH levels were significantly lower (p < 0.05), while there were no significant differences in FSH levels between groups (p > 0.05).
Internal iliac artery ligation in the treatment of obstetric hemorrhage leads to dilation of the ovarian arteries and reversed flow in the ovarian branches of the uterine arteries. These change the blood supply to the ovaries and impair ovarian reserve.
髂内动脉结扎是产科出血的治疗方法之一。该干预措施对卵巢功能的长期影响尚不清楚。本研究旨在评估髂内动脉结扎对卵巢血供和卵巢储备的影响。
招募了 6 名因产科出血而行髂内动脉结扎的患者作为研究组。选择了年龄、产次和分娩后时间相同但未行髂内动脉结扎术的 6 名妇女作为对照组。在术后 6 至 26 个月，对卵巢动脉和子宫动脉卵巢支进行定量数字血管造影和血管 CT 检查。在月经周期第 3 天采集血样，用于随后分析卵泡刺激素（FSH）和抗苗勒管激素（AMH）的激素水平。
在血管 CT 检查中，研究组可见子宫动脉卵巢支出现逆向血流：造影剂从卵巢动脉流向卵巢，从子宫动脉卵巢支流向子宫动脉。对照组未见造影剂从卵巢流向子宫动脉卵巢支。卵巢动脉定量数字血管造影显示，研究组的卵巢动脉平均直径明显增宽（p<0.05）。研究组的 AMH 水平明显降低（p<0.05），而两组间 FSH 水平无显著差异（p>0.05）。
产科出血治疗中髂内动脉结扎导致卵巢动脉扩张和子宫动脉卵巢支逆向血流。这些变化改变了卵巢的血液供应，损害了卵巢储备功能。
