Clamp across the utero-ovarian vessels and ligament to reduce uterine bleeding

Placing a large clamp across the utero-ovarian ligaments bilaterally is a rapid and simple means of occluding uterine blood flow through ovarian artery collaterals. It will not completely control bleeding from uterine atony or placenta accreta spectrum but may decrease blood loss while other interventions, such as hysterectomy, are being attempted. It also effectively ligates the fallopian tubes, precluding future conception without in vitro fertilization if the uterus is retained. Therefore, if future fertility is a consideration, ligating the utero-ovarian vessels and sparing the fallopian tubes is the preferred approach, although this procedure is more time consuming, difficult, and risky (iatrogenic broad ligament hematoma).