The Role of Bilateral Internal Artery Ligation in Minimizing Blood Loss Prior to Cesarean Hysterectomy in Patients with Abnormally Invased Placenta

Background: Pathological placental implantation is one symptom of a spectrum of illnesses known as abnormally invasive placenta (AIP). It's linked to a higher risk of serious bleeding in the mother and a less-than-ideal outcome for the baby. As maternal age rises and the number of women undergoing uterus surgeries rises, more and more women are at danger. Aim and objectives: To assess the efficacy of bilateral internal iliac artery ligation in reducing intraoperative blood loss in patients with a confirmed intraoperative diagnosis of AIP who are undergoing Cesarean hysterectomy. Subjects and methods: A total of 60 cases of AIP were identified at the outpatient obstetrics and gynecology clinics at Al Azhar University Hospitals and then transferred to the appropriate ultrasound unit for trans-abdominal and trans-vaginal ultrasonography. Every single patient was classified as either: Group 1 (Cases): 30 women who underwent caesarean hysterectomies after bilateral IIA ligation, Thirty patients in Group 2 (Controls) were treated exclusively with caesarean hysterectomy. Result: There was no significant distinction among both of the study groups regarding Intraoperative complications. In group 2, the hemoglobin level dropped considerably 48 hours after surgery. The estimated blood loss was much greater in the control group, whereas the duration of the surgery was substantially shorter in the cases group. Conclusion: Regarding our results When performing a caesarean hysterectomy on a patient with AIP, it is not suggested to routinely do a ligation of both internal iliac arteries to prevent excessive blood loss during the procedure. To verify our findings, larger-scale investigations are required.