SlideShare a Scribd company logo

Harnessing the great arteries in p.p.h dr vivekpatkar

•Download as PPT, PDF•
•
D
drvivekpatkar

Hypogastric Artery Ligation

Health & Medicine
1 of 39
Dr. Vivek D. Patkar M.D., D.G.O Ex Honorary Professor LTMMC & LTMGH Sion, Mumbai.
Definition of PPH ,[object Object],[object Object],[object Object]
Statistics ( L.T.M.G.H ) from 1999 to 2005 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Statistics ( L.T.M.G.H ) from 1999 to 2005 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CLASSES OF HAEMORRHAGE ,[object Object],[object Object],[object Object],Class I Class II Class III Class IV % Blood Loss 15 20 - 25 30 - 35 40 Pulse Normal 100 120 > 140 Systolic BP Normal Normal 70 - 80 < 60 Mean arterial Pressure 80 - 90 80 - 90 50 – 70 < 50
Statistics Sample Years: 2001 & 2002 PPH Causes No. UTERINE : Atony Retained placenta Placenta praevia Abruptio placenta Adherent placenta Rupture Ut and Lacerations Inversion of Uterus 56 28 14 1 NON UTERINE : Lower gen tr. Lacer Br Lig Hematoma Coagulopathy 10 2 5 Total 116 INTRACTABLE PPH Causes No. UTERINE : Atony Retained placenta Placenta praevia Abruptio placenta Adherent placenta Rupture Ut and Lacerations Inversion of Uterus 8 7 5 1 NON UTERINE : Lower gen tr. Lacer Br Lig Hematoma Coagulopathy 2 1 2 Total 26
PRELUDE TO SURGERY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TACTICAL ANALOGUE
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
71 UAL’s done ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
UAL ,[object Object],[object Object],[object Object]
Procedure ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANATOMY of HAL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANATOMY of HA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ANATOMY of HA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Division of Hypogastric Artery (Gross CM) Post Division Ant Division Parietal Parietal Visceral Ilio lumbar Obturator Obl. Umbelical Lateral sacral Int pudendal Uterine Superior Gluteal Inf Gluteal Vaginal Sup. Vesical Inf. Vesical M. Haemorrhoidal
Collateral Circulation ( Gross) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Haemodynamics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Haemodynamics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Procedure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Procedure ( Contd) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Procedure ( Contd) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Int. Iliac/Success rate Authors Year Method No of Women Success Rates Evans et al 1985 Internal iliac artery ligation 14 6/14 (42.8%) Fernandez et al 1988 Internal iliac artery ligation 8 8/8 (100%) Chattopadhyay et al 1990 Bilateral Hypogastric artery ligation 29 19/29 ( 65%) Ledee et al 2001 Bilateral Hypogastric artery ligation 48 43/48 (89.5%)
Failures (2% -- 8%) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Incase of Failures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
THANK YOU In Surgical Impasse and Intractable PPH the best defense is swift offense, viz. HAL - Michael Smith
 

Recommended

Ureteric endometriosis
Ureteric endometriosisUreteric endometriosis
Ureteric endometriosisAsha Reddy
 
Step wise pelvic devascularisation
Step wise pelvic devascularisationStep wise pelvic devascularisation
Step wise pelvic devascularisationNiranjan Chavan
 
Postpartum hemorrhage
Postpartum hemorrhagePostpartum hemorrhage
Postpartum hemorrhageMahantesh Karoshi
 
ENDOMETRIOSIS
ENDOMETRIOSISENDOMETRIOSIS
ENDOMETRIOSISNARENDRA MALHOTRA
 
KỸ THUẬT B LYNCH
KỸ THUẬT B LYNCHKỸ THUẬT B LYNCH
KỸ THUẬT B LYNCHSoM
 
Uma mogs2015result
Uma mogs2015resultUma mogs2015result
Uma mogs2015resultuma tripathi
 
Mm accreta
Mm accretaMm accreta
Mm accretaFaculty of Medicine,Zagazig University,EGYPT
 
Vaginoplasty
Vaginoplasty Vaginoplasty
Vaginoplasty College of Medicine - Dr.Ma'ad Al-Jubouri
 

Recommended

Ureteric endometriosis
Ureteric endometriosisUreteric endometriosis
Ureteric endometriosisAsha Reddy
 
Step wise pelvic devascularisation
Step wise pelvic devascularisationStep wise pelvic devascularisation
Step wise pelvic devascularisationNiranjan Chavan
 
Postpartum hemorrhage
Postpartum hemorrhagePostpartum hemorrhage
Postpartum hemorrhageMahantesh Karoshi
 
ENDOMETRIOSIS
ENDOMETRIOSISENDOMETRIOSIS
ENDOMETRIOSISNARENDRA MALHOTRA
 
KỸ THUẬT B LYNCH
KỸ THUẬT B LYNCHKỸ THUẬT B LYNCH
KỸ THUẬT B LYNCHSoM
 
Uma mogs2015result
Uma mogs2015resultUma mogs2015result
Uma mogs2015resultuma tripathi
 
Mm accreta
Mm accretaMm accreta
Mm accretaFaculty of Medicine,Zagazig University,EGYPT
 
Vaginoplasty
Vaginoplasty Vaginoplasty
Vaginoplasty College of Medicine - Dr.Ma'ad Al-Jubouri
 
Myomectomy laparoscopic-vs-laparotomy 2
Myomectomy laparoscopic-vs-laparotomy 2Myomectomy laparoscopic-vs-laparotomy 2
Myomectomy laparoscopic-vs-laparotomy 2Mohamed Walaa El Deeb
 
Ureteric Injury at Gynaecological Surgery
Ureteric Injury at Gynaecological SurgeryUreteric Injury at Gynaecological Surgery
Ureteric Injury at Gynaecological SurgerySujoy Dasgupta
 
FIGO guidelines on Placenta Accreta Spectrum Disorders: Conservative manage...
FIGO guidelines on Placenta Accreta Spectrum Disorders: Conservative manage...FIGO guidelines on Placenta Accreta Spectrum Disorders: Conservative manage...
FIGO guidelines on Placenta Accreta Spectrum Disorders: Conservative manage...Aboubakr Elnashar
 
Hysteroscopy complications
Hysteroscopy complicationsHysteroscopy complications
Hysteroscopy complicationsDr. Aisha M Elbareg
 
Complications of laparoscopy
Complications of laparoscopy Complications of laparoscopy
Complications of laparoscopy Aboubakr Elnashar
 
Uterine uterine brace suture slideshare
Uterine uterine brace suture slideshareUterine uterine brace suture slideshare
Uterine uterine brace suture slideshareMahmoud Abdel-Aleem
 
Lavh 1
Lavh 1Lavh 1
Lavh 1Manjushree Boob
 
Surgical Management of Postpartum Hemorrhage
Surgical Management of Postpartum HemorrhageSurgical Management of Postpartum Hemorrhage
Surgical Management of Postpartum HemorrhageRajesh Gajbhiye
 
Vaginoplasty. An update and future concern
Vaginoplasty. An update and future concernVaginoplasty. An update and future concern
Vaginoplasty. An update and future concernMahmoud Abdel-Aleem
 
3 New removable uterine compression sutures
3 New removable uterine compression sutures3 New removable uterine compression sutures
3 New removable uterine compression suturesmuhammad al hennawy
 
Internal iliac ligation
Internal iliac ligationInternal iliac ligation
Internal iliac ligationSnehaRonge
 
platelet rich plasma gynecology
platelet rich plasma gynecologyplatelet rich plasma gynecology
platelet rich plasma gynecologymuhammad al hennawy
 
Stress urinary incontinence dr. kawita bapat
Stress urinary incontinence dr. kawita bapatStress urinary incontinence dr. kawita bapat
Stress urinary incontinence dr. kawita bapatKawita Bapat
 
Tubal factor infertility
Tubal factor infertilityTubal factor infertility
Tubal factor infertilityAboubakr Elnashar
 
Management of cesarean scar pregnancy
Management of cesarean scar pregnancyManagement of cesarean scar pregnancy
Management of cesarean scar pregnancyOsama Warda
 
Uterine arteriovenous malformation Acquired Dr Mamta Lekhi
Uterine arteriovenous malformation Acquired Dr Mamta LekhiUterine arteriovenous malformation Acquired Dr Mamta Lekhi
Uterine arteriovenous malformation Acquired Dr Mamta LekhiLifecare Centre
 
Baloon tamponade in management of postpartum haemorrhage
Baloon tamponade in management of postpartum haemorrhageBaloon tamponade in management of postpartum haemorrhage
Baloon tamponade in management of postpartum haemorrhageAboubakr Elnashar
 
Jain point a viable option in contraindications of palmers point
Jain point a viable option in contraindications of palmers pointJain point a viable option in contraindications of palmers point
Jain point a viable option in contraindications of palmers pointjainnutan
 
Difficult c section
Difficult c sectionDifficult c section
Difficult c sectionNARENDRA MALHOTRA
 
Laparoscopic Surgery in Pregnancy: Precautions and Complications
Laparoscopic Surgery in Pregnancy: Precautions and ComplicationsLaparoscopic Surgery in Pregnancy: Precautions and Complications
Laparoscopic Surgery in Pregnancy: Precautions and ComplicationsWorld Laparoscopy Hospital
 
Intra Partum Cardiotocography - dr vivek patkar
Intra Partum Cardiotocography - dr vivek patkarIntra Partum Cardiotocography - dr vivek patkar
Intra Partum Cardiotocography - dr vivek patkardrvivekpatkar
 
Surgical management of pph at tertiary center
Surgical management of pph at tertiary centerSurgical management of pph at tertiary center
Surgical management of pph at tertiary centerdrmcbansal
 

More Related Content

What's hot

Myomectomy laparoscopic-vs-laparotomy 2
Myomectomy laparoscopic-vs-laparotomy 2Myomectomy laparoscopic-vs-laparotomy 2
Myomectomy laparoscopic-vs-laparotomy 2Mohamed Walaa El Deeb
 
Ureteric Injury at Gynaecological Surgery
Ureteric Injury at Gynaecological SurgeryUreteric Injury at Gynaecological Surgery
Ureteric Injury at Gynaecological SurgerySujoy Dasgupta
 
FIGO guidelines on Placenta Accreta Spectrum Disorders: Conservative manage...
FIGO guidelines on Placenta Accreta Spectrum Disorders: Conservative manage...FIGO guidelines on Placenta Accreta Spectrum Disorders: Conservative manage...
FIGO guidelines on Placenta Accreta Spectrum Disorders: Conservative manage...Aboubakr Elnashar
 
Complications of laparoscopy
Complications of laparoscopy Complications of laparoscopy
Complications of laparoscopy Aboubakr Elnashar
 
Uterine uterine brace suture slideshare
Uterine uterine brace suture slideshareUterine uterine brace suture slideshare
Uterine uterine brace suture slideshareMahmoud Abdel-Aleem
 
Surgical Management of Postpartum Hemorrhage
Surgical Management of Postpartum HemorrhageSurgical Management of Postpartum Hemorrhage
Surgical Management of Postpartum HemorrhageRajesh Gajbhiye
 
Vaginoplasty. An update and future concern
Vaginoplasty. An update and future concernVaginoplasty. An update and future concern
Vaginoplasty. An update and future concernMahmoud Abdel-Aleem
 
3 New removable uterine compression sutures
3 New removable uterine compression sutures3 New removable uterine compression sutures
3 New removable uterine compression suturesmuhammad al hennawy
 
Internal iliac ligation
Internal iliac ligationInternal iliac ligation
Internal iliac ligationSnehaRonge
 
Stress urinary incontinence dr. kawita bapat
Stress urinary incontinence dr. kawita bapatStress urinary incontinence dr. kawita bapat
Stress urinary incontinence dr. kawita bapatKawita Bapat
 
Management of cesarean scar pregnancy
Management of cesarean scar pregnancyManagement of cesarean scar pregnancy
Management of cesarean scar pregnancyOsama Warda
 
Uterine arteriovenous malformation Acquired Dr Mamta Lekhi
Uterine arteriovenous malformation Acquired Dr Mamta LekhiUterine arteriovenous malformation Acquired Dr Mamta Lekhi
Uterine arteriovenous malformation Acquired Dr Mamta LekhiLifecare Centre
 
Baloon tamponade in management of postpartum haemorrhage
Baloon tamponade in management of postpartum haemorrhageBaloon tamponade in management of postpartum haemorrhage
Baloon tamponade in management of postpartum haemorrhageAboubakr Elnashar
 
Jain point a viable option in contraindications of palmers point
Jain point a viable option in contraindications of palmers pointJain point a viable option in contraindications of palmers point
Jain point a viable option in contraindications of palmers pointjainnutan
 
Laparoscopic Surgery in Pregnancy: Precautions and Complications
Laparoscopic Surgery in Pregnancy: Precautions and ComplicationsLaparoscopic Surgery in Pregnancy: Precautions and Complications
Laparoscopic Surgery in Pregnancy: Precautions and ComplicationsWorld Laparoscopy Hospital
 

What's hot (20)

Myomectomy laparoscopic-vs-laparotomy 2
Myomectomy laparoscopic-vs-laparotomy 2Myomectomy laparoscopic-vs-laparotomy 2
Myomectomy laparoscopic-vs-laparotomy 2
 
Ureteric Injury at Gynaecological Surgery
Ureteric Injury at Gynaecological SurgeryUreteric Injury at Gynaecological Surgery
Ureteric Injury at Gynaecological Surgery
 
FIGO guidelines on Placenta Accreta Spectrum Disorders: Conservative manage...
FIGO guidelines on Placenta Accreta Spectrum Disorders: Conservative manage...FIGO guidelines on Placenta Accreta Spectrum Disorders: Conservative manage...
FIGO guidelines on Placenta Accreta Spectrum Disorders: Conservative manage...
 
Hysteroscopy complications
Hysteroscopy complicationsHysteroscopy complications
Hysteroscopy complications
 
Complications of laparoscopy
Complications of laparoscopy Complications of laparoscopy
Complications of laparoscopy
 
Uterine uterine brace suture slideshare
Uterine uterine brace suture slideshareUterine uterine brace suture slideshare
Uterine uterine brace suture slideshare
 
Lavh 1
Lavh 1Lavh 1
Lavh 1
 
Surgical Management of Postpartum Hemorrhage
Surgical Management of Postpartum HemorrhageSurgical Management of Postpartum Hemorrhage
Surgical Management of Postpartum Hemorrhage
 
Vaginoplasty. An update and future concern
Vaginoplasty. An update and future concernVaginoplasty. An update and future concern
Vaginoplasty. An update and future concern
 
3 New removable uterine compression sutures
3 New removable uterine compression sutures3 New removable uterine compression sutures
3 New removable uterine compression sutures
 
Internal iliac ligation
Internal iliac ligationInternal iliac ligation
Internal iliac ligation
 
platelet rich plasma gynecology
platelet rich plasma gynecologyplatelet rich plasma gynecology
platelet rich plasma gynecology
 
Stress urinary incontinence dr. kawita bapat
Stress urinary incontinence dr. kawita bapatStress urinary incontinence dr. kawita bapat
Stress urinary incontinence dr. kawita bapat
 
Tubal factor infertility
Tubal factor infertilityTubal factor infertility
Tubal factor infertility
 
Management of cesarean scar pregnancy
Management of cesarean scar pregnancyManagement of cesarean scar pregnancy
Management of cesarean scar pregnancy
 
Uterine arteriovenous malformation Acquired Dr Mamta Lekhi
Uterine arteriovenous malformation Acquired Dr Mamta LekhiUterine arteriovenous malformation Acquired Dr Mamta Lekhi
Uterine arteriovenous malformation Acquired Dr Mamta Lekhi
 
Baloon tamponade in management of postpartum haemorrhage
Baloon tamponade in management of postpartum haemorrhageBaloon tamponade in management of postpartum haemorrhage
Baloon tamponade in management of postpartum haemorrhage
 
Jain point a viable option in contraindications of palmers point
Jain point a viable option in contraindications of palmers pointJain point a viable option in contraindications of palmers point
Jain point a viable option in contraindications of palmers point
 
Difficult c section
Difficult c sectionDifficult c section
Difficult c section
 
Laparoscopic Surgery in Pregnancy: Precautions and Complications
Laparoscopic Surgery in Pregnancy: Precautions and ComplicationsLaparoscopic Surgery in Pregnancy: Precautions and Complications
Laparoscopic Surgery in Pregnancy: Precautions and Complications
 

Viewers also liked

Intra Partum Cardiotocography - dr vivek patkar
Intra Partum Cardiotocography - dr vivek patkarIntra Partum Cardiotocography - dr vivek patkar
Intra Partum Cardiotocography - dr vivek patkardrvivekpatkar
 
Surgical management of pph at tertiary center
Surgical management of pph at tertiary centerSurgical management of pph at tertiary center
Surgical management of pph at tertiary centerdrmcbansal
 
Management of Post-partum hemorrhage (PPH)
Management of Post-partum hemorrhage (PPH)Management of Post-partum hemorrhage (PPH)
Management of Post-partum hemorrhage (PPH)Sandesh Kamdi
 
Is there a role for internal iliac artery ligation in post cesarean uterine a...
Is there a role for internal iliac artery ligation in post cesarean uterine a...Is there a role for internal iliac artery ligation in post cesarean uterine a...
Is there a role for internal iliac artery ligation in post cesarean uterine a...Apollo Hospitals
 
Fht interpretation & management
Fht interpretation & managementFht interpretation & management
Fht interpretation & managementBabak Jebelli
 
Mini Sprint® Brackets – los brackets de calidad para su práctica
Mini Sprint® Brackets – los brackets de calidad para su prácticaMini Sprint® Brackets – los brackets de calidad para su práctica
Mini Sprint® Brackets – los brackets de calidad para su prácticaDentoshop Gac-vdw
 
[REU] Poster Presentation
[REU] Poster Presentation[REU] Poster Presentation
[REU] Poster PresentationC.j. Velasquez
 
ORTODONCIA PAOLA OCHOA
ORTODONCIA PAOLA OCHOAORTODONCIA PAOLA OCHOA
ORTODONCIA PAOLA OCHOAPaola Ochoa
 
Brakets
BraketsBrakets
Braketsximegg
 
Marketing aplicado a la odontología con especialización en Ortodoncia
Marketing aplicado a la odontología con especialización en OrtodonciaMarketing aplicado a la odontología con especialización en Ortodoncia
Marketing aplicado a la odontología con especialización en OrtodonciaPablo Ozu
 

Viewers also liked (20)

Intra Partum Cardiotocography - dr vivek patkar
Intra Partum Cardiotocography - dr vivek patkarIntra Partum Cardiotocography - dr vivek patkar
Intra Partum Cardiotocography - dr vivek patkar
 
Surgical management of pph at tertiary center
Surgical management of pph at tertiary centerSurgical management of pph at tertiary center
Surgical management of pph at tertiary center
 
Management of Post-partum hemorrhage (PPH)
Management of Post-partum hemorrhage (PPH)Management of Post-partum hemorrhage (PPH)
Management of Post-partum hemorrhage (PPH)
 
Pph1 [autosaved]
Pph1 [autosaved]Pph1 [autosaved]
Pph1 [autosaved]
 
08 ctg isam ws
08 ctg isam ws08 ctg isam ws
08 ctg isam ws
 
Ctg 2016
Ctg 2016Ctg 2016
Ctg 2016
 
Is there a role for internal iliac artery ligation in post cesarean uterine a...
Is there a role for internal iliac artery ligation in post cesarean uterine a...Is there a role for internal iliac artery ligation in post cesarean uterine a...
Is there a role for internal iliac artery ligation in post cesarean uterine a...
 
Fht interpretation & management
Fht interpretation & managementFht interpretation & management
Fht interpretation & management
 
Quickclear
QuickclearQuickclear
Quickclear
 
Mini Sprint Brackets
Mini Sprint BracketsMini Sprint Brackets
Mini Sprint Brackets
 
Bioquick
BioquickBioquick
Bioquick
 
Mini Sprint® Brackets – los brackets de calidad para su práctica
Mini Sprint® Brackets – los brackets de calidad para su prácticaMini Sprint® Brackets – los brackets de calidad para su práctica
Mini Sprint® Brackets – los brackets de calidad para su práctica
 
[REU] Poster Presentation
[REU] Poster Presentation[REU] Poster Presentation
[REU] Poster Presentation
 
Evo of ortho brackets 2
Evo of ortho brackets 2Evo of ortho brackets 2
Evo of ortho brackets 2
 
ORTODONCIA PAOLA OCHOA
ORTODONCIA PAOLA OCHOAORTODONCIA PAOLA OCHOA
ORTODONCIA PAOLA OCHOA
 
Brackets angiee (1)
Brackets angiee (1)Brackets angiee (1)
Brackets angiee (1)
 
Innovacion en Brackets de Autoligado, reporte publicado por el Dr. Antonino S...
Innovacion en Brackets de Autoligado, reporte publicado por el Dr. Antonino S...Innovacion en Brackets de Autoligado, reporte publicado por el Dr. Antonino S...
Innovacion en Brackets de Autoligado, reporte publicado por el Dr. Antonino S...
 
Biomecanica
BiomecanicaBiomecanica
Biomecanica
 
Brakets
BraketsBrakets
Brakets
 
Marketing aplicado a la odontología con especialización en Ortodoncia
Marketing aplicado a la odontología con especialización en OrtodonciaMarketing aplicado a la odontología con especialización en Ortodoncia
Marketing aplicado a la odontología con especialización en Ortodoncia
 

Similar to Harnessing the great arteries in p.p.h dr vivekpatkar

Controlling of profuse pelvic haemorrhage in obstetrics and
Controlling of profuse pelvic haemorrhage in obstetrics andControlling of profuse pelvic haemorrhage in obstetrics and
Controlling of profuse pelvic haemorrhage in obstetrics andSadaf Khan
 
Vulvovaginal hematoma - Dr Mitra Saxena
Vulvovaginal hematoma - Dr Mitra SaxenaVulvovaginal hematoma - Dr Mitra Saxena
Vulvovaginal hematoma - Dr Mitra SaxenaSurekhaTayade4
 
Conservative management of spleenic injury by dr. raheel anis.
Conservative management of spleenic injury by dr. raheel anis.Conservative management of spleenic injury by dr. raheel anis.
Conservative management of spleenic injury by dr. raheel anis.Raheel Anis
 
Applied anatomy and physiology of liver
Applied anatomy and physiology of liverApplied anatomy and physiology of liver
Applied anatomy and physiology of liverArun Aru
 
Postpartum hemarrhage new.ppt
Postpartum hemarrhage new.pptPostpartum hemarrhage new.ppt
Postpartum hemarrhage new.pptTashriiq_Ahmed
 
POST PARTUM HEMORRHAGE.pptx
POST PARTUM HEMORRHAGE.pptxPOST PARTUM HEMORRHAGE.pptx
POST PARTUM HEMORRHAGE.pptxAhmedBayomi11
 
POST PARTUM HEMORRHAGE.pptx
POST PARTUM HEMORRHAGE.pptxPOST PARTUM HEMORRHAGE.pptx
POST PARTUM HEMORRHAGE.pptxAhmedBayomi11
 
Coa pathophysiology
Coa pathophysiologyCoa pathophysiology
Coa pathophysiologyIndia CTVS
 
Blunt trauma abdomen
Blunt trauma abdomenBlunt trauma abdomen
Blunt trauma abdomenpune2013
 
Congenital diaphragmatic hernia by Dr. Varsha Atul Shah
Congenital diaphragmatic hernia by Dr. Varsha Atul ShahCongenital diaphragmatic hernia by Dr. Varsha Atul Shah
Congenital diaphragmatic hernia by Dr. Varsha Atul ShahVarsha Shah
 
Rush Exam with Ultrasound Cases.pdf
Rush Exam with Ultrasound Cases.pdfRush Exam with Ultrasound Cases.pdf
Rush Exam with Ultrasound Cases.pdfAlireza Bahmani
 
Postpartum hemorrhge final دراسات عليا.pptx
Postpartum hemorrhge final دراسات عليا.pptxPostpartum hemorrhge final دراسات عليا.pptx
Postpartum hemorrhge final دراسات عليا.pptxabdelnaser5
 
Imaging of pelvic floor weakness
Imaging of pelvic floor weaknessImaging of pelvic floor weakness
Imaging of pelvic floor weaknessPranjitThapa
 
Management of postpartum haemorrhage
Management of postpartum haemorrhageManagement of postpartum haemorrhage
Management of postpartum haemorrhageArya Anish
 
Splenic trauma
Splenic traumaSplenic trauma
Splenic traumanazmi3
 

Similar to Harnessing the great arteries in p.p.h dr vivekpatkar (20)

Controlling of profuse pelvic haemorrhage in obstetrics and
Controlling of profuse pelvic haemorrhage in obstetrics andControlling of profuse pelvic haemorrhage in obstetrics and
Controlling of profuse pelvic haemorrhage in obstetrics and
 
Pelvic trauma
Pelvic traumaPelvic trauma
Pelvic trauma
 
Vulvovaginal hematoma - Dr Mitra Saxena
Vulvovaginal hematoma - Dr Mitra SaxenaVulvovaginal hematoma - Dr Mitra Saxena
Vulvovaginal hematoma - Dr Mitra Saxena
 
Conservative management of spleenic injury by dr. raheel anis.
Conservative management of spleenic injury by dr. raheel anis.Conservative management of spleenic injury by dr. raheel anis.
Conservative management of spleenic injury by dr. raheel anis.
 
liver trauma.pptx
liver trauma.pptxliver trauma.pptx
liver trauma.pptx
 
Applied anatomy and physiology of liver
Applied anatomy and physiology of liverApplied anatomy and physiology of liver
Applied anatomy and physiology of liver
 
Stapler hemorrhoidectomy 3
Stapler hemorrhoidectomy 3Stapler hemorrhoidectomy 3
Stapler hemorrhoidectomy 3
 
Postpartum hemarrhage new.ppt
Postpartum hemarrhage new.pptPostpartum hemarrhage new.ppt
Postpartum hemarrhage new.ppt
 
POST PARTUM HEMORRHAGE.pptx
POST PARTUM HEMORRHAGE.pptxPOST PARTUM HEMORRHAGE.pptx
POST PARTUM HEMORRHAGE.pptx
 
POST PARTUM HEMORRHAGE.pptx
POST PARTUM HEMORRHAGE.pptxPOST PARTUM HEMORRHAGE.pptx
POST PARTUM HEMORRHAGE.pptx
 
Coa pathophysiology
Coa pathophysiologyCoa pathophysiology
Coa pathophysiology
 
Blunt trauma abdomen
Blunt trauma abdomenBlunt trauma abdomen
Blunt trauma abdomen
 
Paed.ppt
Paed.pptPaed.ppt
Paed.ppt
 
Congenital diaphragmatic hernia by Dr. Varsha Atul Shah
Congenital diaphragmatic hernia by Dr. Varsha Atul ShahCongenital diaphragmatic hernia by Dr. Varsha Atul Shah
Congenital diaphragmatic hernia by Dr. Varsha Atul Shah
 
Postpartum hemorrhage for undergraduate
Postpartum hemorrhage for undergraduatePostpartum hemorrhage for undergraduate
Postpartum hemorrhage for undergraduate
 
Rush Exam with Ultrasound Cases.pdf
Rush Exam with Ultrasound Cases.pdfRush Exam with Ultrasound Cases.pdf
Rush Exam with Ultrasound Cases.pdf
 
Postpartum hemorrhge final دراسات عليا.pptx
Postpartum hemorrhge final دراسات عليا.pptxPostpartum hemorrhge final دراسات عليا.pptx
Postpartum hemorrhge final دراسات عليا.pptx
 
Imaging of pelvic floor weakness
Imaging of pelvic floor weaknessImaging of pelvic floor weakness
Imaging of pelvic floor weakness
 
Management of postpartum haemorrhage
Management of postpartum haemorrhageManagement of postpartum haemorrhage
Management of postpartum haemorrhage
 
Splenic trauma
Splenic traumaSplenic trauma
Splenic trauma
 

Recently uploaded

👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...rajnisinghkjn
 
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxSwetaba Besh
 
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...Janvi Singh
 
Difference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesDifference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesMedicoseAcademics
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationMedicoseAcademics
 
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana GuptaLifecare Centre
 
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...chanderprakash5506
 
Circulatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsCirculatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsMedicoseAcademics
 
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableJanvi Singh
 
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...gragneelam30
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...dishamehta3332
 
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...amritaverma53
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Janvi Singh
 
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowChennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowtanudubay92
 
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...gragneelam30
 
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...Janvi Singh
 
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service AvailableLucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Availablesoniyagrag336
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableSteve Davis
 

Recently uploaded (20)

👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
 
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
 
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
 
Difference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesDifference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac Muscles
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their Regulation
 
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
 
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
Russian Call Girls In Pune 👉 Just CALL ME: 9352988975 ✅❤️💯low cost unlimited ...
 
Circulatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsCirculatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanisms
 
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
 
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
 
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
 
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book nowChennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
Chennai ❣️ Call Girl 6378878445 Call Girls in Chennai Escort service book now
 
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
 
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
 
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service AvailableLucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 

Harnessing the great arteries in p.p.h dr vivekpatkar

  • 1. Dr. Vivek D. Patkar M.D., D.G.O Ex Honorary Professor LTMMC & LTMGH Sion, Mumbai.
  • 2.
  • 3.
  • 4.
  • 5.
  • 6. Statistics Sample Years: 2001 & 2002 PPH Causes No. UTERINE : Atony Retained placenta Placenta praevia Abruptio placenta Adherent placenta Rupture Ut and Lacerations Inversion of Uterus 56 28 14 1 NON UTERINE : Lower gen tr. Lacer Br Lig Hematoma Coagulopathy 10 2 5 Total 116 INTRACTABLE PPH Causes No. UTERINE : Atony Retained placenta Placenta praevia Abruptio placenta Adherent placenta Rupture Ut and Lacerations Inversion of Uterus 8 7 5 1 NON UTERINE : Lower gen tr. Lacer Br Lig Hematoma Coagulopathy 2 1 2 Total 26
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22. Division of Hypogastric Artery (Gross CM) Post Division Ant Division Parietal Parietal Visceral Ilio lumbar Obturator Obl. Umbelical Lateral sacral Int pudendal Uterine Superior Gluteal Inf Gluteal Vaginal Sup. Vesical Inf. Vesical M. Haemorrhoidal
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32. Int. Iliac/Success rate Authors Year Method No of Women Success Rates Evans et al 1985 Internal iliac artery ligation 14 6/14 (42.8%) Fernandez et al 1988 Internal iliac artery ligation 8 8/8 (100%) Chattopadhyay et al 1990 Bilateral Hypogastric artery ligation 29 19/29 ( 65%) Ledee et al 2001 Bilateral Hypogastric artery ligation 48 43/48 (89.5%)
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38. THANK YOU In Surgical Impasse and Intractable PPH the best defense is swift offense, viz. HAL - Michael Smith
  • 39.