The Boldest Procedure Possible for Checking the Bleeding - A new look at an old operation, and a series of 13 cases from an Australian hospital

Ligation of the internal iliac (hypogastric) arteries in cases of massive obstetric and gynaecological haemorrhage can be a life-saving operation, but it has never been widely practised in the British gynaecological tradition. There may be historical reasons for this. A series of 13 cases is presented from one Australian hospital over a 5-year period, and a very low rate of Caesarean hysterectomy is demonstrated. A wider knowledge of the technique is recommended. Alternative methods of management, including angiographic embolization and the use of prostaglandins are discussed.