Transcatheter pelvic arterial embolisation for control of obstetric and gynaecological haemorrhage.
We present a 5-year experience of pelvic arterial embolisation at two centres in the UK, and emphasise the role of interventional radiology in the treatment of obstetric and gynaecological haemorrhage. A total of 31 women underwent pelvic embolization:19 patients had complete medical records, and of these, two women had antepartum haemorrhage, 12 women had primary postpartum haemorrhage (PPH), four women had secondary PPH and one woman had a haemorrhage following termination of pregnancy (TOP). The source of the haemorrhage was only identified in four women (21.1%). All patients underwent selective embolisation of the uterine artery or anterior divisional branch of the internal iliac artery with successful haemorrhage control in 17 patients (89.4%) and no immediate complications. Haemorrhage continued despite embolisation in two patients; both proceeded to surgery. Selective pelvic embolisation is a safe and effective treatment for acute obstetric or gynaecological haemorrhage and should be part of the management algorithm for PPH.
Ratnam
L A
LA
Department of Radiology, Royal Berkshire Hospital, Reading, UK.
Gibson
M
M
Sandhu
C
C
Torrie
P
P
Chandraharan
E
E
Belli
A M
AM
D000328:Adult; D017541:Aneurysm, False / Q000150:complications / Q000175:diagnosis; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D006473:Postpartum Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D015641:Radiography, Interventional; D055357:Uterine Artery Embolization; D055815:Young Adult
D006490:Hemostatics