Naga Rachana Paidi, Budihal Sohana P, Chennuru Bharathna
Obstetrics and Gynaecology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Oct 5;16(10):e70908. doi: 10.7759/cureus.70908. eCollection 2024 Oct.
Postpartum hemorrhage (PPH) is one of the leading causes of maternal morbidity and mortality worldwide, particularly in low-resource settings. Despite advances in obstetric care, PPH continues to pose significant challenges, especially when conservative management fails. In such cases, more aggressive surgical interventions become necessary to control hemorrhage and preserve the patient's fertility. The bilateral ligation of the anterior division of the internal iliac arteries (IIAL) is a fertility-preserving procedure. This procedure has been widely adopted in obstetric practice, particularly for managing cases of uterine atony, placenta previa, and other conditions associated with massive hemorrhage. However, despite its proven efficacy, IIAL remains underutilized due to the technical expertise required and the limited exposure among obstetricians during training. This study aims to advocate for increased training and awareness to enhance its adoption in clinical practice.
产后出血（PPH）是全球孕产妇发病和死亡的主要原因之一，在资源匮乏地区尤为如此。尽管产科护理取得了进展，但PPH仍然带来重大挑战，尤其是在保守治疗失败时。在这种情况下，需要采取更积极的手术干预措施来控制出血并保留患者的生育能力。双侧髂内动脉前支结扎术（IIAL）是一种保留生育能力的手术。该手术已在产科实践中广泛应用，特别是用于处理子宫收缩乏力、前置胎盘和其他与大出血相关的情况。然而，尽管其疗效已得到证实，但由于所需的技术专长以及产科医生在培训期间接触有限，IIAL的使用率仍然较低。本研究旨在倡导加强培训和提高认识，以促进其在临床实践中的应用。
