Citation Information :
Sanjaya I, Suwardewa T, Kusuma A, Putra I, Wiradnyana A, Prayudi P. Improving the Outcome of Cesarean Hysterectomy for Adhesive Placenta with Internal Iliac Artery Ligation Procedure. J South Asian Feder Obs Gynae 2022; 14 (3):279-282.
Introduction: The increased rate of cesarean delivery has been related to increased incidence of the adhesive placenta in the last three decades. Improved management of adhesive placenta will increase the survival rate. Internal iliac artery or hypogastric artery (HA) ligation was one of the prophylactic techniques to prevent massive bleeding and expected to increase the survival rate.
Aims: To determine whether HA or internal iliac artery ligation can improve the outcome of cesarean hysterectomy in cases with the adhesive placenta.
Methods: This is a retrospective descriptive study involving 50 patients with confirmed adhesive placenta who underwent cesarean hysterectomy from March 2017 to January 2021 in Sanglah General Hospital. Data were presented in percentage and analyzed using the Chi-square test or Fisher's exact test.
Results: The patients had a mean age of 32.5 years, with a median number of children being two and a median history of cesarean section of two times. None of the patients had a previous history of curettage. Based on the comparison of the results of patients who underwent iliac artery ligation, it was found that patients who were not treated had more complications of bladder rupture, repeated laparotomy, and had more internal bleeding (p-value 0.643, 0.630, and 0.645, consecutively).
Conclusion: Patients who were not treated had more complications of bladder rupture, repeated laparotomy, and had more internal bleeding.
Refaie W, Shabana A, Fawzy M. Prophylactic bilateral internal iliac artery ligation for management of low-lying placenta accreta: a prospective study. Tanta Med J 2014;42(4):146. DOI: 10.4103/1110-1415.145278.
Jauniaux E, Chantraine F, Silver RM, et al. The International Federation of Gynecology and Obstetrics. FIGO consensus guidelines on placenta accreta spectrum disorders: Epidemiology. Int J Gynecol Obstet 2018;140(3):265. DOI: 10.1002/ijgo.12407.
Agostini TCF, Figueiredo R, Warmbrand G, et al. Placental adhesion disorder: Magnetic resonance imaging features and a proposal for a structured report. Radiol Bras 2020;53(5):329–336. DOI: 10.1590/0100-3984.2019.0037.
Kementerian Kesehatan Indonesia. Pusat Data dan Informas-Kementerian Kesehatan Republik Indonesia. 2019.
El Gelany S, Ibrahim EM, Mohammed M, et al. Management of bleeding from morbidly adherent placenta during elective repeat caesarean section: retrospective-record-based study. BMC Pregnan Childbirth 2019;19(1). DOI: 10.1186/s12884-019-2244-4.
World Health Organization. W. Maternal mortality. J Kentucky Med Assoc 2019;74:601.
WHO. Maternal mortality. 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality.
Achadi EL. Kematian maternal dan neonatal d indonesia. Rapat Kerja Kesehat. Nas. Kementeri. Kesehat. RI. Tangerang 2019;13.
Selçuk İ, Uzuner B, Boduc E, et al. Step-by-step ligation of the internal iliac artery. J Turkish Ger Gynecol Assoc 2019;20:123–128 (2019). DOI: 10.4274/jtgga.galenos.2018.2018.0124.
Yildiz Ç, Bozoklu Akkar Ö, Karakuş S, et al. Hypogastric artery ligation for obstetrical hemorrhage: clinical experience in a tertiary care center. Turkish J Med Sci 2015;45:1312–1316. DOI: 10.3906/sag-1407-102.
Chitragari G, Schlosser FJ, Ochoa Chaar CI, et al. Consequences of hypogastric artery ligation, embolization, or coverage. J Vasc Surg 2015;62(5):1340–1347.e1. DOI: 10.1016/j.jvs.2015.08.053.
Fayyaz S, Kaur B. Blood, sweat & tears - internal artery ligation–life saving procedure. meddocsonline.org. Ann Obstet Gynecol 2020;3(1):1017.
Goh W, Zalud I. Placenta accreta: diagnosis, management and the molecular biology of the morbidly adherent placenta. J Matern Fetal Neonatal Med 2016;29(11):1795–1800. DOI: 10.3109/14767058.2015.1064103.
Aggarwal R, Suneja A, Vaid NB, et al. Morbidly adherent placenta: a critical review. J Obstet Gynecol India 2012;62(1):57–61. DOI: 10.1007/s13224-012-0149-5.
Berg CJ, Atrash HK, Koonin LM, et al. Pregnancy-related mortality in the United States, 1987–1990. Obstet Gynecol 1996;88(2):161–167. DOI: 10.1016/0029-7844(96)00135-4.