Pelvic artery embolization in the management of obstetric hemorrhage.
We studied the role of pelvic artery embolization in management of obstetric hemorrhage by retrospective analysis of 50 cases of obstetric hemorrhage in a tertiary care referral hospital where this procedure was used. Uterine and or internal iliac artery embolization was performed for the management of postpartum hemorrhage (39 cases; 78%), post abortal bleeding (6 cases; 12%) and gestational trophoblastic disease (4 cases; 8%). In one case of postpartum hemorrhage procedure could not be performed due to arterial spasm (2%). Prophylactic embolization was carried out in one case of placenta accreta. The mean age of the women was 27 years and 54% were primiparas. In six women embolization was done after hysterectomy failed to control pelvic hemorrhage. One fourth of women had coagulopathy at the time of presentation. There were five cases of pelvic hematoma and three cases of arteriovenous malformations. The success rate of the procedure was 94% and the procedure was unsuccessful for controlling bleeding in three women. There were no major procedure related complications. Thus, pelvic artery embolization is an effective alternative to surgery in controlling obstetric hemorrhage and as a fertility and life-saving procedure.
Sidhu
Harpreet Kaur
HK
Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. drharpreet_sidhu@hotmail.com
Prasad
Grv
G
Jain
Vanita
V
Kalra
Jaswinder
J
Gupta
Vivek
V
Khandelwal
Niranjan
N
D000328:Adult; D001165:Arteriovenous Malformations / Q000150:complications; D004621:Embolization, Therapeutic; D005260:Female; D006406:Hematoma / Q000150:complications; D006801:Humans; D007083:Iliac Artery; D010921:Placenta Accreta / Q000628:therapy; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D055988:Uterine Artery