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J Korean Soc Radiol. 2019 Jan;80(1):88-97. English. Original Article. https://doi.org/10.3348/jksr.2019.80.1.88
Kwon Y , So YH , Kim BJ , Kim SM , Choi YH , Moon MH .
Department of Radiology, Seoul National University Hospital, Seoul, Korea.
Department of Radiology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea. sorock71@snu.ac.kr
Department of Obstetrics and Gynecology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea.
Abstract

Purpose

To evaluate the clinical efficacy and safety of uterine artery embolization (UAE) using N-butyl-2-cyanoacrylate (NBCA) in patients with postpartum hemorrhage (PPH).

Materials and Methods

From February 2010 to May 2018, 14 patients (age: 28–39 years; mean: 33 years) underwent UAE using NBCA among 82 patients with PPH. Medical records were retrospectively reviewed to evaluate the patients characteristics, cause of PPH, embolization procedure, and outcomes.

Results

Angiograms revealed extravasation (n = 10) or pseudoaneurysm (n = 4) in all patients. The causes of PPH were hysterotomy or hysterectomy related arterial injury (n = 11), cervical laceration (n = 2), and abnormal placentation (n = 1). UAE was performed with NBCA in all patients. Additional UAE with gelatin sponge particles was performed in two patients. Additional non-uterine artery embolization was performed in three patients. Coagulopathy was found in five (35.7%) patients. The technical and clinical success rates were 92.9% and 85.7%, respectively. One patient died from multi-organ failure eight days after UAE. One patient with abnormal placentation had pelvic organ ischemia due to multiple pelvic artery embolization.

Conclusion

UAE using NBCA is safe and effective for the patients with PPH showing extravasation or pseudoaneurysm.

Copyright © 2019. Korean Association of Medical Journal Editors.