Angiographic embolization in the management of obstetrical hemorrhage

Yoon, Bo Hyun; Kim, Mi Ha; Syn, Hee Chul; Moon, Jeong Bin; Jun, Jong Kwan; Oh, Soo Young; Park, Joong Shin; Kim, Seok Hyun; Lee, Taek Sang; Chung, Jin Wook; Park, Jae Hyung

Abstract

OBJECTIVE
To investigate whether emergency selective arterial embolization may serve as a safe and effective alternative treatment in the management of intractable pregnancy-associated hemorrhage.
METHODS
Between February 1992 and March 1999, 20 patients at Seoul National University Hospital underwent angiographic embolization to control obstetrical hemorrhage. In all cases, hemostatic embolization was performed because of intractable hemorrhage unresponsive to conservative management. All available hospital records were reviewed and detailed to collect adequate clinical data such as specific leading complication, clinical status, estimated blood loss and blood replacement requirements, length of procedure, used emboli, complications associated with the procedure, and its results.
RESULTS
We have experienced the successful embolization in 18 of 20 patients of pregnancy-related hemorrhage from the different causes. One of these successful cases required two embolization attempts. Two of these patients needed surgical treatment because of rebleeding after the embolization. The mean length of the time for the procedure was 96.4+/-50.1 minutes (range; 50-260 min.). The average length of hospitalization was 10.4+/-7.7 days (range; 1-36 days). No major complication related to the embolization was found. Two women became pregnant after embolization.
CONCLUSIONS
This study indicates that angiographic embolization is a safe and effective method for the control of pregnancy-related hemorrhagic complications unresponsive to conservative management and that it allows maintenance of reproductive ability.