NCT03129035

Bilateral Internal Iliac Artery Ligation Before Cesarean Hysterectomy

Bilateral Internal Iliac Artery Ligation Before Cesarean Hysterectomy : A Randomized Controlled Trial

• Status: Unknown
• Phase: N/A
• Study type: Interventional
• Enrollment: 100 (estimated)
• Sponsor: Cairo University · Academic / Other
• Sex: Female
• Age: 20 Years – 44 Years
• Healthy volunteers: Not accepted

Summary

All women with placenta accreta will be managed by upper segment cesarean section followed by cesarean hysterectomy without attempts of placental removal. Women were randomized to either bilateral internal iliac artery ligation before hysterectomy and after fetal extraction or no additional intervention

Detailed description

All women with placenta accreta will be managed by upper segment cesarean section followed by cesarean hysterectomy without attempts of placental removal. Women were randomized to either bilateral internal iliac artery ligation before hysterectomy and after fetal extraction or no additional intervention. Midline incision in the all patients is preferred. The retroperitoneal space was entered at the level of common iliac bifurcation and followed to the point of division into the external and internal iliac arteries. The ureter was retracted medially by gentle finger dissection, revealing the retroperitoneal anatomy. The fat and loose connective tissue around the IIA and vein were removed and a right-angle clamp was passed beneath the IIA from the lateral to the medial side approximately 4 cm distal to its origin. Using an absorbable suture, the IIA was ligated doubly in all cases . Pulsations of the external iliac and femoral arteries were identified after internal iliac ligation. The procedure was then repeated on the other side.

Conditions

• Placenta Accreta

Interventions

Type	Name	Description
PROCEDURE	Cesarean hystrectomy	Upper segment cesarean section followed by fetal extraction and cesarean hystrectomy started without any attempts of placental removal
PROCEDURE	Internal iliac artery ligation	The retroperitoneal space was entered at the level of common iliac bifurcation and followed to the point of division into the external and internal iliac arteries. The ureter was retracted medially by gentle finger dissection, revealing the retroperitoneal anatomy. The fat and loose connective tissue around the IIA and vein were removed and a right-angle clamp was passed beneath the IIA from the lateral to the medial side approximately 4 cm distal to its origin. Using an absorbable suture, the IIA was ligated doubly in all cases . Pulsations of the external iliac and femoral arteries were identified after internal iliac ligation. The procedure was then repeated on the other side

Timeline

• Start date: 2017-05-01
• Primary completion: 2017-12-01
• Completion: 2018-02-01
• First posted: 2017-04-26
• Last updated: 2017-04-26

Locations

1 site across 1 country: Egypt