[Uterine artery embolisation to treat severe haemorrhage following legal abortion].
The aim of this paper is to present a case of hemorrhagic complication following a legal abortion treated with uterine embolisation. A 45-year-old woman, with a history of one caesarean section and seven legal induced abortions, requested legal induced abortion at 12 weeks of amenorrhea. Legal induced abortion was performed as a day case using vacuum aspiration with a plastic cannula under general anaesthesia. Severe haemorrhage, with an estimated blood loss of 800 ml, occurred during the procedure. Bleeding was not related to cervical laceration, incomplete abortion, or uterine perforation. Surgical conservative procedures and intravenous use of sulprostone (Nalador) failed to control haemorrhage. The patient underwent uterine artery embolisation with Curaspon, a porcine-derived gelfoam, used for the temporary occlusion of the visceral arteries. Successful hemostasis was obtained. The patient presented no complication related to the procedure. Severe haemorrhage following legal induced procedure is rarely reported. Emergency arterial embolisation may offer an effective modality of treatment.
Cravello
L
L
Département de gynécologie-obstétrique, hôpital de La Conception, 147, boulevard Baille, 13885 Marseille cedex 05, France. ludovic.cravello@ap-hm.fr
Mimari
R
R
Agostini
A
A
Pellegrin
V
V
Limet
L
L
Bartoli
J-M
JM
D000029:Abortion, Legal / Q000009:adverse effects*; D001158:Arteries; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012307:Risk Factors; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000209:etiology / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*