title: Transcatheter arterial embolisation for the management of obstetric haemorrhage associated with placental abnormality in 40 cases.
abstract: OBJECTIVE
  To evaluate pelvic artery embolisation (PAE) in the emergency management of intractable postpartum haemorrhage (PPH) associated with placenta accreta (PA).
  
  
  METHODS
  Forty such patients (PAE for PPH/PA) were retrospectively reviewed. Medical records were reviewed regarding the delivery and PAE procedure. Follow-up gynaecological outcomes after PAE were obtained by telephone interviews.
  
  
  RESULTS
  Technical success was achieved in all women (100 %). The initial clinical success rate was 82.5 % (33/40). Three patients with PA underwent hysterectomy after PAE failed to stop the bleeding within 24 h after the embolisation. The other three patients underwent re-embolisation (two patients underwent re-embolisation on the next day and one patient had undergone re-embolisation 6 h after the first embolisation), and bleeding had stopped eventually. The clinical success rate was 92.5 %. There were four cases of immediate complications, such as, pelvic pain, nausea and urticaria. There were three late minor complications, temporary menopause, but no late major complications. After the procedure, 35 patients resumed normal menstruation, including two uncomplicated pregnancies. One patient expired owing to disseminated intravascular coagulopathy and intracerebral haemorrhage, despite successful embolisation.
  
  
  CONCLUSIONS
  PAE can be performed safely and effectively for patients with PPH and PA and can preserve the uterus in many patients.
authors.affiliation: Department of Radiology, CHA Bundang Medical Center, CHA University, 351 Yatap-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-712, Republic of Korea.
authors.forename: Sook Min
authors.initials: SM
authors.lastname: Hwang
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; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D010921:Placenta Accreta / Q000000981:diagnostic imaging / Q000628:therapy*; D006473:Postpartum Hemorrhage / Q000000981:diagnostic imaging / Q000628:therapy*; D011247:Pregnancy; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics