Fertility following ligation of internal iliac arteries for life-threatening obstetric haemorrhage

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 f uture fertility in 12 women who had internal iliac ligation to control seve re obstetric haemorrhage: in 10 out of the 12 women, BIL was successful. Of the two women who subsequently needed emergency hysterectomy, one woman di ed of disseminated intravascular coagulation. Of the eight women we were ab le to followup to assess reproductive performance, two did not desire futur e fertility. Three had subsequent pregnancies (50%), of whom two proceeded to term. We conclude that BIL is a safe and effective procedure for treatin g life-threatening obstetric haemorrhage with preservation of future fertil ity, This technique should be performed more often when indicated.