Bilateral Uterine Artery Ligation, Intrapartum or Postpartum Hemorrhage, Ovarian Reserve Markers, Pregnancy Outcome
Conditions
Brief summary
The aim of this study is to assess the possible negative effects of uterine artery ligation on ovarian reserve markers and subsequent pregnancy outcomes
Detailed description
One of the most common surgical methods for preserving fertility is uterine artery ligation. It is simple to do and effective at reducing Postpartum hemorrhage after delivery . Additionally, it is rather safe and permits future childbearing for the patients.
Interventions
PROCEDUREBilateral uterine artery ligation
Bilateral UAL was done 2 cm under the Kerr incision (lower segment transverse). A 2-Vicryl absorbable suture (Ethicon, Neuilly-surSeine, France) was introduced from the anterior to posterior views of the myometrium 2-3 cm medial to the descending part of the uterine vessels within an avascular area in the broad ligament and tied. Following the surgery, the uterine tone and hemorrhage were managed.
Sponsors
Tanta University
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
* 120 females aged from 20 to 35 years old * with Postpartum hemorrhage or intrapartum hemorrhage after cesarean section * did not respond to medical therapy * performed successful bilateral uterine artery ligation for hemorrhage management.
Exclusion criteria
* The presence of male factor or tubal factor. * Hypertension, autoimmune disease, morbid obesity, absence of lactation diabetes millets, vascular disease, smoking or the use of alcohol. * The presence of additional surgery or medical disease. * Detection of a uterine anomaly, history of intrauterine growth restriction in previous pregnancies. * Usage of a hormonal therapy through the research.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ovarian reserve by anti-mullerian hormone | 24 months after bilateral uterine artery ligation. | Anti-mullerian hormone (AMH) level will be determined using a two-sided immunoassay that will be enzymatically amplified (ELISA). AMH was recorded at 6, 12 and 24 months after bilateral uterine artery ligation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Ovarian reserve by follicle stimulating hormone | 24 months after bilateral uterine artery ligation. | follicle stimulating hormone (FSH) level will be determined using a two-sided immunoassay that will be enzymatically amplified (ELISA). FSH was recorded at 6, 12 and 24 months after bilateral uterine artery ligation. |
| Ovarian reserve by antral follicle counts | 24 months after bilateral uterine artery ligation. | antral follicle counts were recorded at 6, 12 and 24 months after bilateral uterine artery ligation. |
| Percent of subsequent pregnancy cases | 24 months after bilateral uterine artery ligation. | patients were asked about their desire for pregnancy in the future The data of subsequent pregnancy cases following bilateral UAL primary were recorded and follow-up was done at 6, 12 and 24 months after BUAL. |
Countries
Egypt
Outcome results
None listed