Prophylactic Bilateral Uterine Artery Ligation During Cesaerean Section in Women at Risk of Postpartum Hemorrhage

Solyman, Ayman ElSayed; ElKhouly, Nabih Ibrahim; Hosni, Nehad Mahmoud; Sharaf EL-Din, Samar Talaat; Salama, Heba Farag

doi:10.21608/egyfs.2025.441450

Prophylactic Bilateral Uterine Artery Ligation During Cesaerean Section in Women at Risk of Postpartum Hemorrhage

Document Type : Original Article

Authors

¹ Ass.Professor of Obstetrics and Gynecology – Faulty of Medicine- Menouﬁa University, Egypt

² Professor of Obstetrics and Gynecology – Faulty of Medicine- Menouﬁa University, Egypt

³ Resident at Menouf General Hospital

⁴ Ass.Professor of Obstetrics and Gynecology - Faulty of Medicine- Menouﬁa University, Egypt

10.21608/egyfs.2025.441450

Abstract

Objective : The purpose of this study is to Evaluate the effect of bilateral uterine artery ligation on operative and post-operative blood loss in C.S in high risk patients of Postpartum Hge.
Background: Obstetric hemorrhage is a principal cause of maternal death in both high-and low-income countries. Because it is a leading cause of maternal mortality and morbidity, and most fatal cases are due to substandard care , Bilateral uterine artery ligation (BUAL) is a quick and easy surgical procedure that can be coupled with uterotonics to prevent PPH in high-risk cases such as pla-centa previa. It is also the ﬁrst step in a uterine devascu-larization approach that can bring about bleeding control in established cases of PPH and it can be used prophylac-tically to reduce the incidence of PPH in high-risk cases.
Methods : This is a prospective Randomized clinical trial that was conducted among 484 women attending the la-bor ward at Menouﬁa university hospital.
Results: Intraoperative blood loss during cesarean was highly signiﬁcant lower in the BUAL group than in the control group (524.26±12.17 vs 610.58±18.41mL; P<0.001).Hb deﬁcit postoperative was also signiﬁcant-ly lower in the BUAL group than in the control group (0.63±0.14 vs 1.76±0.57 g/dl ; P<0.001). There was a sta-tistical signiﬁcant difference in the AFC of non lactating women after 3 months in the BUAL group than in the control group (10.10±1.3 vs 12.6±.09 , P<0.001).
Conclusion: BUAL during cesarean was found to be an effective method for decreasing blood loss during and af-ter cesarean delivery among women at risk of uterine ato-ny and subsequent PPH.

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