Fertility and pregnancy outcome following pelvic arterial embolization for severe post-partum haemorrhage. A cohort study.
BACKGROUND
Pelvic arterial embolization is a safe, effective life-saving procedure in post-partum haemorrhage, but little information is yet available about its impact on menstruation and fertility.


METHODS
A cohort of 28 women who underwent pelvic embolization for post-partum haemorrhage in our tertiary centre was studied. Patients were contacted by telephone to obtain long-term outcome for menstruation, clinical signs of estrogen insufficiency, desire for fertility and subsequent pregnancies.


RESULTS
We found no menstrual abnormalities or signs of early menopause among the 17 patients we were able to reach. Six women expressed a clear desire for subsequent pregnancies. Five patients reported a total of six pregnancies (one biochemical pregnancy, one early miscarriage and four deliveries). The four patients with complete gestations gave birth to healthy babies, but post-partum haemorrhage recurred for all and led to two hysterectomies. No undesired pregnancies occurred.


CONCLUSIONS
Embolization in post-partum haemorrhage appears to be a safe procedure that does not impair subsequent menstruation and fertility. Recurrence of severe post-partum haemorrhage may occur at subsequent deliveries.
Salomon
L J
LJ
Service de Gynécologie-Obstétrique and Radiologie, Hôpital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, 157 rue de la Porte-de-Trivaux, 92141 Clamart cedex, France.
deTayrac
R
R
Castaigne-Meary
V
V
Audibert
F
F
Musset
D
D
Ciorascu
R
R
Frydman
R
R
Fernandez
H
H
D000328:Adult; D001158:Arteries; D015331:Cohort Studies; D004621:Embolization, Therapeutic; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008598:Menstruation; D010388:Pelvis / Q000098:blood supply*; D006473:Postpartum Hemorrhage / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012008:Recurrence; D012720:Severity of Illness Index