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Failure of uterine artery embolization for controlling postpartum hemorrhage
Author(s) -
Park Ji Kwon,
Shin Tae Bum,
Baek Jong Chul,
Shin Jeong Kyu,
Choi Won Jun,
Lee Soon Ae,
Lee Jong Hak,
Paik Won Young
Publication year - 2011
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2010.01463.x
Subject(s) - medicine , uterine atony , uterine artery embolization , placenta accreta , embolization , uterus , placenta , uterotonic , obstetrics , surgery , pregnancy , hysterectomy , oxytocin , fetus , biology , genetics
Aim: We evaluated the efficacy of uterine artery embolization (UAE) for controlling postpartum hemorrhage (PPH). Materials and Methods: Between January 2008 and December 2009, 23 women with intractable PPH underwent UAE. Specific diagnoses included uterine atony ( n = 10), placenta accreta ( n = 8), puerperal hematoma ( n = 2) and placental polyp ( n = 3). Results: Of 10 patients with uterine atony, treatment with UAE failed in two women with severe vasoconstriction. One patient developed lumbosacral plexopathy. All eight patients with placenta accreta were treated successfully with the placement of multiple sutures in the placental bed and UAE. Two of the three women with placental polyps were treated successfully with UAE and packing of the uterus. Conclusions: Embolization should follow resuscitation for vascular collapse. In the case of an adherent placenta, embolization is more effective with the placement of multiple sutures in the placental bed or compression of the placental bed.