title: Usefulness of pelvic artery embolization in cesarean section compared with vaginal delivery in 176 patients.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of transcatheter arterial embolization of the pelvic arteries for the treatment of postpartum hemorrhage (PPH) associated with cesarean section compared with vaginal delivery.
  
  
  METHODS
  A retrospective analysis of 176 patients undergoing transcatheter arterial embolization of the pelvic arteries for PPH from January 2006 through August 2011 was conducted at two institutions. The mean patient age was 33.9 years (range, 24-46 years). Data including delivery details, hematology and coagulation results, embolization details, and clinical outcomes were collected. Technical success was defined as cessation of bleeding on angiography or angiographically successful embolization of the bleeding artery. Clinical success was defined as the obviation of repeated embolization or surgical intervention.
  
  
  RESULTS
  The technical success rate was 98.8% (n = 174), and the clinical success rate was 89.7% (n = 158). Among 176 patients, 71 had cesarean sections, and 105 underwent normal vaginal deliveries. Of the 105 patients who underwent normal vaginal deliveries, 11 (10.5%) required repeat embolization or surgical intervention. Of the 71 patients who had cesarean sections, 7 (9.8%) required repeat embolization or surgical intervention. The clinical success rate and complication rate were not related to the mode of delivery. All women resumed menses after transcatheter arterial embolization, and most (n = 125) described their menses as unchanged. Subsequent spontaneous pregnancies occurred in 13 women.
  
  
  CONCLUSIONS
  The cesarean mode of delivery is not a predictor of poorer outcomes of transcatheter arterial embolization; however, further study is needed to clarify this relationship.
authors.affiliation: Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Lee
authors.forename: Gyeong Sik
authors.initials: GS
authors.lastname: Jeon
authors.forename: Man Deuk
authors.initials: MD
authors.lastname: Kim
authors.forename: Sang Heum
authors.initials: SH
authors.lastname: Kim
authors.forename: Jong Tae
authors.initials: JT
authors.lastname: Lee
authors.forename: Min Jeong
authors.initials: MJ
authors.lastname: Choi
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015897:Comorbidity; D004621:Embolization, Therapeutic / Q000706:statistics & numerical data*; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply*; D011183:Postoperative Complications / Q000453:epidemiology*; D006473:Postpartum Hemorrhage / Q000453:epidemiology* / Q000628:therapy*; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics