Korean J Perinatol.  2009 Mar;20(1):36-43.

The indications, effectiveness and complications of the selective arterial embolization in the management of obstetrical hemorrhage

• Park BR
• Lee NH
• Kim YS
• Mun ST
• Sunwoo JG
• Bae DH
• Gang CH

Abstract

PURPOSE:The objective of this study was to evaluate the indications, effectiveness and complications associated with uterine arterial embolization as an alternative treatment of obstetrical hemorrhage.
METHODS
From January 2006 to December 2008, 25 patients who underwent angiographic embolization for the obstetrical hemorrhage that was not responsive to conventional treatments, like obstetric maneuvers and uterotonic drugs, were included in our study. All medical records were reviewed and detailed clinical data such as clinical status, underlying conditions, amount of transfusion, embolized arteries, hospital stay, the success rate and the complications were collected.
RESULTS
We have experienced clinically successful embolization in 22 (88%) of 25 patients with obstetrical hemorrhage resulting from various causes. After embolization, the patients' vital signs were stabilized. The causes of hemorrhage were atony of uterus (n=10), myomectomy during cesarean section (n=6), abnormal placentation (n=5), arterio-venous malformation (n=3), and cervical pregnancy (n=1). The average amount of blood transfusion was 7.2 units (range; 0~39 units). The average length of the time for the procedure was 55 minutes (range: 25~96 minutes). The average duration of hospitalization was 5.5 days (range: 2~14 days). In 22 patients, menses resumed spontaneously after procedures. The main complications after embolization were numbness and pain on lower extremities (n=1), and hypomenorrhea (n=1).
CONCLUSION
The atrerial embolization is one of the safe and effective procedures that offers patients an alternative to hysterectomy for the treatment of intractable postpartum hemorrhage.

Keyword

Arterial embolization; Obstetrical hemorrhage

MeSH Terms

Arteries
Blood Transfusion
Cesarean Section
Female
Hemorrhage
Hospitalization
Humans
Hypesthesia
Hysterectomy
Length of Stay
Lower Extremity
Medical Records
Menstruation Disturbances
Placentation
Postpartum Period
Pregnancy
Uterus
Vital Signs