Question

Order of ligation of devascularization in PPH

• A. Uterine artery, pudendal artery, vaginal artery
• B. Uterine artery, internal iliac, obturator artery
• C. Uterine artery, ovarian artery, internal iliac artery
• D. Uterine artery, ovarian artery, vaginal artery

Answer 1

The Correct Option is C

Postpartum hemorrhage (PPH) management often involves surgical intervention to control uterine bleeding by devascularization. The correct sequence for ligation in such cases is crucial to effectively reduce blood flow to the uterus while ensuring that vital pelvic organs remain perfused.

The typical order of arterial ligation for devascularization in PPH is:

• Uterine artery ligation: Located lateral to the uterus where it traverses the broad ligament, this is usually the first artery targeted to rapidly diminish uterine blood supply.
• Ovarian artery ligation: This artery contributes to the dual blood supply of the uterus. Ligation of the ovarian artery further reduces perfusion pressure.
• Internal iliac artery ligation: Also known as hypogastric artery ligation, this reduces pelvic blood flow and systemic blood pressure within the pelvic vascular bed.

Therefore, the correct order is: Uterine artery, ovarian artery, internal iliac artery.