Objective : The main objective was to assess the efficacy of ‘stepwise uterine devascularisation in management of uncontrollable postpartum haemorrhage.

Study Design : Stepwise uterine devascularisation was performed in 23 patients to control intractable postpartum haemorrhage not responding to classic conservative management. The technique includes three successive steps, so if bleeding is not controlled by one step, next step is done.

The steps were:
Step-I: Bilateral uterine vessel ligation,
Step-II: Bilateral low uterine vessel ligation,
Step-III: Bilateral Ovarian vessel ligation.

Results : Mean age of these patients was 27.6 years. Uterine atony and placenta previa were most common causes of postpartum haemorrhage in this series. The procedure was effective in 22 out of 23 patients. The survival rate was 100%. No major complications were noted.

Conclusion : Stepwise uterine devascularisation is a simple, safe and effective alternative to hysterectomy in management of severe intractable postpartum haemorrhage