Index IntroductionMethodsResultsDiscussionConclusion Severe hemorrhage may occur during delivery of patients with pathologically adherent placentaSay no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Obtain an original assay (MAP) and techniques such as adjuvant intraoperative ligation of the hypogastric artery at the time of cesarean hysterectomy (C-hyst) have been implemented with the goal of decreasing intraoperative blood loss. However, little research has been devoted to long-term postsurgical sequelae as a result of elective hypogastric artery ligation or embolization in the setting of a cyst. Hypogastric artery disruption has classically been performed in cases of trauma or as an unwanted side effect of vascular operations and, although generally considered benign, can cause ischemic complications, including buttock claudication, spinal cord ischemia, and sexual dysfunction. The results of this retrospective cohort study show no significant long-term consequences of hypogastric artery ligation or embolization in patients with MAP treated with C-hyst. Keywords: Invasvie Placenta Hypogastric artery ligation Cesarean hysterectomy Introduction Hemorrhage is a problem when treating patients with pathologically adherent placenta (MAP), a condition in which the placental chorionic villi implant directly into the uterine wall. The incidence of MAP has increased dramatically over the past decade, currently affecting approximately 1 in 300 pregnancies (1). The average blood loss at delivery without additional procedures such as hypogastric artery ligation or balloon occlusion is 3,000 to 5,000 mL, and the maternal mortality rate has been reported as high as 7% (2). Planned cesarean hysterectomy (C-hyst) is the most common surgical treatment option for patients with MAP. Several additional procedures can be performed, such as hypogastric artery ligation, balloon occlusion placement, or embolization, which have been shown to reduce blood loss, in some cases up to 1,000 ml (3,4). However, little is known about the long-term procedure. Term sequelae of hypogastric artery ligation or embolization in the setting of hysteria C. Disruption of the hypogastric artery can cause ischemic complications, including buttock claudication, spinal cord ischemia, and sexual dysfunction (5,6) . The aim of this study was to evaluate the long-term sequelae of patients with MAP undergoing hist C with concomitant ligation or embolization of the hypogastric artery. Methods This study was approved by the Institutional Review Board on our intuition. A retrospective cohort analysis was performed of all consecutive patients with MAP who underwent C-hysteria at a single institution between January 2011 and 2016. A total of 35 patients were identified and contacted for a telephone survey discussing symptoms post-procedural events potentially related to ligation or embolization of the hypogastric artery. Patient demographics, operative reports, and clinical notes were also reviewed. The control group consisted of patients with MAP who underwent hist C without concomitant ligation or embolization of the hypogastric artery. The study group included patients with MAP undergoing hist C with concomitant ligation or embolization of the hypogastric artery. Continuous variables were compared using Student's t test and nonparametric Wilcoxon test for means. Categorical variables were compared using Fisher's exact test for proportions. 3..