Postpartum hemorrhage with pelvic arterial embolization, study of 33 cases

J Matern Fetal Neonatal Med. 2019 Feb;32(4):573-578. doi: 10.1080/14767058.2017.1387527. Epub 2017 Oct 16.

Abstract

Objective: To describe our cases of postpartum hemorrhage (PPH) with pelvic arterial embolization (PAE).

Material and methods: All patients with PPH who underwent PAE in our center in the interval 2011-1016 were retrospectively studied, evaluating the technical procedure, clinical results, and subsequent fertility.

Results: There were 33 cases of PPH with PAE. The majority occurred in primiparous women (N = 22, 66.6%) who delivered vaginally (N = 20, 61%). In addition, most PPH with PAE cases had an early onset (N = 26, 79%) and were caused by uterine atony (N = 14, 42.4%). Success of PAE occurred in 27 (81.8%) cases and a satisfactory clinical follow-up was the rule, with 21 (64%) women recovering their normal menstruation, and six (18.2%) becoming pregnant in the following years.

Conclusions: PAE is a safe and efficacious technique with minor complications. Moreover, it allows conservation of the uterus with preservation of fertility.

Keywords: Postpartum hemorrhage; interventional radiology; labor complications; pelvic arteries embolization; uterine atony.

MeSH terms

  • Adult
  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Iliac Artery*
  • Organ Sparing Treatments
  • Postpartum Hemorrhage / therapy*
  • Pregnancy
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult