Efficacy of internal iliac artery ligation for control of post-partum haemorrhage


  • Beeresh C. S. Department of Obstetrics and Gynecology, PESIMSR, Kuppam, Chittor, Andhra Pradesh, India http://orcid.org/0000-0002-1119-5937
  • Divyasree Doopadapalli Department of Obstetrics and Gynecology, PESIMSR, Kuppam, Chittor, Andhra Pradesh, India
  • Krishna L. Department of Obstetrics and Gynecology, PESIMSR, Kuppam, Chittor, Andhra Pradesh, India




Internal iliac artery ligation, Post partum hemorrhage


Background: Pelvic hemorrhage is associated with a great degree of morbidity and mortality and has to be controlled immediately. Ligation of the internal iliac arteries is a method to achieve the goal. We conducted this study to assess the outcome, effectiveness and complications of internal iliac artery ligation (IIAL) in controlling postpartum haemorrhage.

Methods: This study was a retrospective study conducted in a rural tertiary referral centre from April 2015 to March 2018. IIAL was performed in women with PPH either at caesarean section or at laparotomy performed at a variable time after vaginal or caesarean delivery.

Results: Over the study period of 3 years, 29 cases of IIAL were performed. The most common indication for IIAL was atonic PPH. Uterine salvagability was 62% in this study.

Conclusions: All obstetric surgeons should be fully aware of the indications, timing and technical aspects of IIAL. Bilateral internal iliac artery ligation remains a safe, fast, effective and life saving salvage procedure which should be encouraged and used routinely by obstetricians when faced with cases of severe obstetric hemorrhage, especially in young women of low parity.


Trends in Maternal Mortality: 1990 to 2015 Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division: available at; https://afro.who.int/sites/default/files/ 2017-05/trends-in-maternal-mortality-1990-to-2015.pdf.

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Global Health. 2014;2(6):e323-33.

Kelly HA. Ligation of internal iliac arteries for haemorrhage in hysterectomy for carcinoma uteri. Bull Johns Hopkins Hosp. 1894;5:53.

Burchell RC. Internal iliac artery ligation: hemodynamics. Obstet Gynecol. 1964;24:737.

Singh A, Kishore R, Saxena SS. Ligating Internal Iliac Artery: Success beyond Hesitation. J Obstet Gynecol India. 2016;66(S1):S235-S241.

Kabadi YM, Harsha B. Emergency internal iliac artery ligation: a conservative lifesaving procedure. IJRCOG. 2015;4:1364-6.

Simsek Y, Yilmaz E, Celik E. Efficacy of internal iliac artery ligation on the management of postpartum hemorrhage and its impact on the ovarian reserve. J Turk Soc Obstet Gyn. 2012;9(3):153-8.

Patil Y, Kathiriya D, Kshirsagar NS. Role of Internal Iliac Artery Ligation in Control of Pelvic Haemorrhage. Int J Recent Trends Sci Technol. 2014;9(3):461-4.

Joshi V, Otiv S, Majumder R. Internal iliac artery ligation for arresting postpartum haemorrhage. BJOG. 2007;114:356-61.

Perveen F, Memon GU, Rabia S. Use of bilateral internal iliac artery ligation for controlling severe obstetric haemorrhage. Pak J Med Sci. 2011;27(1):94-7.






Original Research Articles