Fertility and pregnancy outcome following pelvic arterial embolization for severe post-partum haemorrhage. A cohort study

Hum Reprod. 2003 Apr;18(4):849-52. doi: 10.1093/humrep/deg168.

Abstract

Background: Pelvic arterial embolization is a safe, effective life-saving procedure in post-partum haemorrhage, but little information is yet available about its impact on menstruation and fertility.

Methods: A cohort of 28 women who underwent pelvic embolization for post-partum haemorrhage in our tertiary centre was studied. Patients were contacted by telephone to obtain long-term outcome for menstruation, clinical signs of estrogen insufficiency, desire for fertility and subsequent pregnancies.

Results: We found no menstrual abnormalities or signs of early menopause among the 17 patients we were able to reach. Six women expressed a clear desire for subsequent pregnancies. Five patients reported a total of six pregnancies (one biochemical pregnancy, one early miscarriage and four deliveries). The four patients with complete gestations gave birth to healthy babies, but post-partum haemorrhage recurred for all and led to two hysterectomies. No undesired pregnancies occurred.

Conclusions: Embolization in post-partum haemorrhage appears to be a safe procedure that does not impair subsequent menstruation and fertility. Recurrence of severe post-partum haemorrhage may occur at subsequent deliveries.

MeSH terms

  • Adult
  • Arteries
  • Cohort Studies
  • Embolization, Therapeutic*
  • Female
  • Fertility*
  • Follow-Up Studies
  • Humans
  • Hysterectomy
  • Menstruation
  • Pelvis / blood supply*
  • Postpartum Hemorrhage / physiopathology*
  • Postpartum Hemorrhage / surgery
  • Postpartum Hemorrhage / therapy*
  • Pregnancy
  • Pregnancy Outcome*
  • Recurrence
  • Severity of Illness Index