The indications, effectiveness and complications of the selective arterial embolization in the management of obstetrical hemorrhage.
- Author:
Bo ra PARK
1
;
Na Hye LEE
;
Yun Sook KIM
;
Seong Taek MUN
;
Jae Gun SUNWOO
;
Dong han BAE
;
Chae Hun GANG
Author Information
1. Department of Obstetrics and Gynecology, University of Soonchunhyang College of Medicine, Soonchunhyang University Chunan Hospital, Chunan, Korea. drsook@schca.ac.kr
- Publication Type:Original Article
- Keywords:
Arterial embolization;
Obstetrical hemorrhage
- MeSH:
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
- From:Korean Journal of Perinatology
2009;20(1):36-43
- CountryRepublic of Korea
- Language:Korean
-
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.
