Bilateral Internal Iliac Artery Ligation for Massive Postpartum Hemorrhage

Objective: This study was performed to evaluate the consequences of Bilateral Internal Iliac Artery Ligation (BIIAL) in severe Postpartum Hemorrhage (PPH).Patients and Methods: This retrospective study was carried out from April 2010 to April 2015 at a tertiary care center of Obstetrics and Gynecology, it involved 109 patients with severe (PPH) managed with BIIAL. Data were collected completely from the medical records of patients. Details regarding risk factors, management, and outcomes were recorded.Results: Totally 109 patients who underwent BIIAL were included in the study. All patients were hemodynamically unstable, abnormal placental insertion was the chief cause of severe (PPH). Uterus was preserved in 60 (55.0%) of cases, seven patients died of complications and/or morbidity associated with hemorrhage.Conclusion: BIIA ligation is an effective therapeutic option for severe (PPH) and should be kept in the armamentarium of the obstetrician during emergency conditions. Increased understanding of the retroperitoneal anatomy is needed to diminish the risk of intraoperative serious complications.