The role of prophylactic internal iliac artery ligation in abnormally invasive placenta undergoing caesarean hysterectomy: a randomized control trial

Abstract

<b>Objective:</b> To identify the role of bilateral internal iliac artery (IIA) ligation on reducing blood loss in abnormally invasive placenta (AIP) undergoing caesarean hysterectomy. <b>Methods:</b> In this parallel-randomized control trial, 57 pregnant females with ultrasound features suggestive of AIP were enrolled. They were randomized into two groups; IIA group (<i>n</i> = 29 cases) performed bilateral IIA ligation followed by caesarean hysterectomies, while Control group (<i>n</i> = 28 cases) underwent caesarean hysterectomy only. The main outcome was the difference in the estimated intraoperative blood loss between the two groups. <b>Results:</b> There was no significant difference between the two groups regarding the intraoperative estimated blood loss (1632 ± 804 versus 1698 ± 1251, <i>p</i> value .83). The operative procedure duration (minutes) (223 ± 66 versus 171 ± 41.4, <i>p</i> value .001) varied significantly between the two groups. <b>Conclusions:</b> Bilateral internal iliac artery ligation, in cases of AIP undergoing caesarean hysterectomy, is not recommended for routine practice to minimize blood loss intraoperatively.