Selective pelvic arterial embolization in the management of obstetric hemorrhage.
OBJECTIVE
Retrospective evaluation of pelvic arterial embolization for the treatment of severe post-partum hemorrhage.


METHODS
Data were collected, from our departmental clinical records, on all patients with life-threatening post-partum hemorrhage managed with arterial embolization between January 2001 and December 2003.


RESULTS
During the period analyzed, there were 29,119 deliveries in our institution. Of these, 27 patients underwent pelvic arterial embolization to control severe hemorrhaging despite conservative management. Of the 27 patients, 22 (81.5%) had a vaginal delivery and 5 had a caesarean section. The major indication for embolization was uterine atony (15 women). Disseminated intravascular coagulation developed in 20 cases (74.1%). There were eight cases (29.6%) who underwent hysterectomy, seven of them pre-embolization. The most frequent vessel embolized was the uterine artery (13 cases; 38.3%). One patient (3.7%) presented complications related to the procedure. The success rate was 96.3%.


CONCLUSIONS
Pelvic arterial embolization is a good therapeutic choice for severe post-partum hemorrhage refractory to conservative treatment measures.
Vegas
Gabriel
G
Obstetrics and Gynecology Service, Hospital Universitario La Paz, Paseo Castellana 261, 28046 Madrid, Spain. gabrielvegas@yahoo.es
Illescas
Tamara
T
Muñoz
Mar
M
Pérez-Piñar
Antonio
A
D000328:Adult; D001158:Arteries; D036861:Delivery, Obstetric; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010388:Pelvis / Q000098:blood supply; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome