title: [Endovascular treatment of obstetric hemorrhage].
abstract: OBJECTIVE
  To evaluate effectiveness and safety of hypogastric artery branches embolization in the treatment of postpartum hemorrhage, hemorrhage associated with cesarean section and termination of pregnancy.
  
  
  METHODS
  All women with intractable bleeding and who were treated by embolization, were included from the period between 1996 to 2010. The retrospective study included 16 women of mean age 30.5 years.
  
  
  RESULTS
  Intractable hemorrhage related to regular delivery occurred 7 times, five times after cesarean section and four times after termination of pregnancy. Seven women (44%) were in hemorrhagic shock during therapeutic embolization. Extravazation was angiographically proved in 50% cases. Embolization was successful in hemorrhage control in 87,5% of women, in two women embolization was repeated for persistent bleeding. There were 21 additional surgical procedures performed in 13 women before embolization including 2 hysterectomies. Two hysterectomies were done after embolization because of infection. In remaining 3 women embolization was done as a primary method of bleeding control. No patient died. In the group of 10 women with maximally 1 surgery before embolization length of hospital stay was 10.1 days in average, while in a group of six women having 2 to 3 surgeries before embolization the hospital stay was 21.2 days in average (p = 0.03).
  
  
  CONCLUSIONS
  Embolization of hypogastric arteries decreases length of hospital stay in patients with obstetric hemorrhage and should be done soon if routine methods of bleeding control fail.
authors.affiliation: Radiologicka klinika LF a FN, Hradec Kralove. antonin.krajina@fnhk.cz
authors.forename: A
authors.initials: A
authors.lastname: Krajina
authors.forename: I
authors.initials: I
authors.lastname: Kalousek
authors.forename: M
authors.initials: M
authors.lastname: Lojík
authors.forename: V
authors.initials: V
authors.lastname: Chovanec
authors.forename: J
authors.initials: J
authors.lastname: Raupach
authors.forename: J
authors.initials: J
authors.lastname: Grepl
authors.forename: O
authors.initials: O
authors.lastname: Renc
authors.forename: V
authors.initials: V
authors.lastname: Reháček
authors.forename: E
authors.initials: E
authors.lastname: Cermáková
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D007044:Hysterectomy; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy; D055815:Young Adult