Korean J Obstet Gynecol.  2009 Jan;52(1):44-52.

Angiographic findings and effect of superselective embolization for early and late postpartum bleeding

• Kim JR
• Cho YK
• Kim HM
• Choi EJ
• Kim DW
• Seo YS
• Lee JY
• Park WI

Abstract

OBJECTIVE
Treatment of postpartum bleeding with uterine artery embolization has been well-described so far. However, angiographic differences between early and late postpartum bleeding has not been elucidated. The purpose of this study was to evaluate angiographic differences between early and late postpartum bleeding and therapeutic effect of superselective embolization.
METHODS
Medical records and angiographic images of 12 patients (7 early and 5 late) with postpartum bleeding were evaluated. Timing of bleeding, mode of delivery, angiographic findings and treatment outcome were primary variables evaluated.
RESULTS
Among 12 patients, 11 patients had been successfully treated with superselective embolization. One patient with amniotic fluid embolism and disseminated intravascular coagulation had expired. Among the early postpartum bleeding, uterine atony was found in every patients except post-cesarean hysterectomy cases. Pseudoaneurysm of uterine artery was found in all patients with late postpartum bleeding.
CONCLUSION
Superselective embolization is an effective method to control postpartum bleeding. Pseudoaneurysm of uterine artery is a main cause of late postpartum bleeding.

Keyword

Postpartum hemorrhage; Therapeutic embolization; Angiography; Pseudoaneurysm

MeSH Terms

Aneurysm, False
Angiography
Disseminated Intravascular Coagulation
Embolism, Amniotic Fluid
Embolization, Therapeutic
Female
Hemorrhage
Humans
Hysterectomy
Medical Records
Postpartum Hemorrhage
Postpartum Period
Pregnancy
Treatment Outcome
Uterine Artery
Uterine Artery Embolization
Uterine Hemorrhage