PubMed · 14077243
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
E NEUMANN. [TRIAL FORCEPS].. https://pubmed.ncbi.nlm.nih.gov/14077243/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Explore the source record for details and available documents.
The organisation of delivery care engages both professional and laypersons. When the Norwegian princess Märtha Louise in 2005 chose to give birth at home instead of in hospital, the intensity of the debate in media increased. Some professionals claim with great persuasion that among selected low-risk women, birth at home or in small midwifery units is as safe as in larger delivery units in hospitals. The scientific evidence for this statement is, however, weak. The Norwegian National Advisory Committee for Maternal Care is an important contributor to this debate. The Committee should, however, pay more respect to the scientific disagreement within the field.
OBJECTIVE: To assess the outcomes of bilateral hypogastric (internal iliac) ligation performed to control intractable pelvic hemorrhage and avoid hysterectomy. METHODS: A review of indications and outcomes for 117 cases of bilateral hypogastric artery ligation over 15 years (1990-2004). RESULTS: Apart from a slight lesion to the hypogastric vein, no complications were observed. Hemorrhage was effectively controlled in all 37 obstetric cases. In 13 of these cases, the uterus was preserved even when there was cervical pregnancy, placenta previa, placental abruption, uterine atony, and uterine rupture, and 4 women were delivered of mature infants. Hemorrhage was effectively controlled in 41 of 80 gynecologic cases. Prophylactic reduction of pelvic blood flow was the indication for the procedure in 39 cases, 5 of whom involving Jehovah's Witnesses adverse to blood transfusion. The uterus was preserved in only a few of the 41 controlled cases, but one woman (so far) was delivered of a mature infant. CONCLUSION: Hypogastric artery ligation was found to be indicated if (1) life-threatening pelvic hemorrhage could not be controlled by conservative methods; (2) prophylactic reduction of pelvic blood flow was needed to prevent anticipated hemorrhage; and (3) preservation of reproductive function was desired. The procedure was found to be safe and usually effective and should be taught during obstetric and gynecologic training.