Clinical and Angiographic Features of Secondary Postpartum Hemorrhage and the Outcomes of Transcatheter Arterial Embolization
10.3348/jksr.2018.79.6.315
- Author:
Seung Dae BAEK
1
;
Ung Rae KANG
;
Seung Woo JI
;
Young Hwan KIM
;
Jung Guen CHA
Author Information
1. Department of Radiology, Daegu Catholic University Medical Center, Catholic University of Daegu College of Medicine, Daegu, Korea. urkang@cu.ac.kr
- Publication Type:Original Article
- From:Journal of the Korean Radiological Society
2018;79(6):315-322
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE:To analyze the clinical and angiographic features with outcome of transcatheter arterial embolization in patients with secondary postpartum hemorrhage.
MATERIALS AND METHODS:Clinical details and angiographic features with assessment of arterial embolization were reviewed in total 38 patients underwent arterial embolization at single tertiary referral center.
RESULTS:Twenty patients (53%) had Cesarean section. The major causes of bleeding were iatrogenic vascular injury, and retained placenta (55%). The patterns of vaginal bleeding were recorded as intermittent (50%), or as persistent (50%). Seven patients (18%) were hemodynamically unstable at presentation. Positive angiographic findings appeared in eighteen patients (47.3%). The frequency of pseudoaneurysm was statistically high in the Cesarean section (p < 0.001). The used embolic agents except gelfoam were N-butyl cyanoacrylate (n = 7), and microcoil (n = 7). Unilateral selective embolization (26.3%) was shown effective in superselective embolization of bleeding focus. Technical and clinical success rate were 100% and 97.4%, respectively with no complication. Sixteen resumed regular menstruation, and one pregnancy were observed in patients with available follow-up of over 6 months.
CONCLUSION:Considerable rate of hemodynamically unstable patients was observed with high rate of positive angiography findings. Given high successful rate and few complications, early angiographic assessment with embolization should be considered.
