Uterine artery ligation Uterine artery ligation. Ligate uterine artery and vein at lower uterine segment, 2–3 cm below level of uterine incision. Place 2–3 cm medial to uterine vessels through myometrium and then lateral to vessels through broad ligament. Palpate ureter medial to lower uterine segment. For hemorrhage, need bilateral sutures—decreases pulse pressure. (Used with permission from Cunningham F, Leveno KJ, Bloom SL, et al. Chapter 41. Obstetrical hemorrhage. In: Cunningham F, Leveno KJ, Bloom SL, et al., eds. Williams Obstetrics. 24th ed. New York, NY: McGraw-Hill; 2013.) Source: Obstetrics, The Johns Hopkins Handbook of Obstetrics and Gynecology Citation: Szymanski LM, Bienstock JL. The Johns Hopkins Handbook of Obstetrics and Gynecology; 2015 Available at: http://obgyn.mhmedical.com/DownloadImage.aspx?image=/data/books/1657/szymanski_ch01_fig-01-24.png&sec=107289975&BookID=1657&ChapterSecID=107289679&imagename= Accessed: October 15, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved