Bleeding battles: Choosing between artery ligation and hysterectomy in postpartum emergencies

- Visibility 183 Views - Downloads 150 Downloads - Permissions - CrossMark - Citation Bleeding battles: Choosing between artery ligation and hysterectomy in postpartum emergencies Postpartum hemorrhage (PPH) is a leading cause of maternal mortality, contributing to 70,000 deaths annually worldwide. Despite advancements in obstetric care, managing severe PPH remains challenging, often requiring a stepwise escalation from medical to surgical interventions. This case series examines three critical PPH scenarios where uterine artery ligation (UAL) and hysterectomy were pivotal in achieving hemostasis. The first case involved a 23-year-old primigravida with placental bed bleeding, managed with B-Lynch sutures and bilateral UAL. The second case featured a 17-year-old with a uterine angle hematoma, controlled via unilateral UAL. The third case, a 29-year-old with refractory hemorrhage, necessitated stepwise devascularization, internal iliac artery ligation, and ultimately supracervical hysterectomy. These cases highlight the importance of timely, tailored surgical interventions—preserving fertility when possible but escalating to hysterectomy when conservative measures fail. A multidisciplinary approach, adherence to protocols, and readiness for advanced interventions are crucial in reducing maternal morbidity and mortality. This series reinforces that while UAL is effective in many cases, hysterectomy remains a lifesaving option in severe PPH, aligning with global efforts to meet Sustainable Development Goal targets for maternal survival. How to Cite This Article Vancouver Rownika S, Kalimuthu K. Bleeding battles: Choosing between artery ligation and hysterectomy in postpartum emergencies [Internet]. Indian J Obstet Gynecol Res. 2026 [cited 2026 May 25];13(2):416-419. Available from: https://doi.org/10.18231/j.ijogr.12961.1767702053 APA Rownika, S., Kalimuthu, K. (2026). Bleeding battles: Choosing between artery ligation and hysterectomy in postpartum emergencies. Indian Journal of Obstetrics and Gynecology Research, 13(2), 416-419. https://doi.org/10.18231/j.ijogr.12961.1767702053 MLA Rownika, Sri, Kalimuthu, Kohila. "Bleeding battles: Choosing between artery ligation and hysterectomy in postpartum emergencies." Indian J Obstet Gynecol Res, vol. 13, no. 2, 2026, pp. 416-419. https://doi.org/10.18231/j.ijogr.12961.1767702053 Chicago Rownika, S., Kalimuthu, K.. "Bleeding battles: Choosing between artery ligation and hysterectomy in postpartum emergencies." Indian J Obstet Gynecol Res 13, no. 2 (2026): 416-419. https://doi.org/10.18231/j.ijogr.12961.1767702053