title: Pelvic arterial embolization in severe obstetric hemorrhage.
abstract: Massive postpartum hemorrhage (PPH) is a major life-threatening complication. When conventional management fails, pelvic arterial embolization (PAE) can be used. The aim of our study was to find out the success rate of PAE in cases of acute PPH, and to study the safety of this procedure in a retrospective case series from a tertiary teaching hospital. Forty-five women with acute PPH were managed by PAE. Hospital charts were reviewed. The most common causes of PPH in cases treated with PAE were lower genital tract injury (40%), placental retention (36%) and uterine atony (13%). The overall success rate was 89%. Five of the 45 women needed additional procedures. The overall complication rate was 9%. We conclude that PAE is a safe and effective procedure for PPH and may prevent hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, University Central Hospital, Helsinki, Finland.
authors.forename: Maiju
authors.initials: M
authors.lastname: Grönvall
authors.forename: Minna
authors.initials: M
authors.lastname: Tikkanen
authors.forename: Maarika
authors.initials: M
authors.lastname: Metsätähti
authors.forename: Mikko
authors.initials: M
authors.lastname: Loukovaara
authors.forename: Jorma
authors.initials: J
authors.lastname: Paavonen
authors.forename: Vedran
authors.initials: V
authors.lastname: Stefanovic
mesh_terms: D000328:Adult; D000792:Angiography; D005260:Female; D006487:Hemostasis / Q000502:physiology; D006801:Humans; D010388:Pelvis / Q000098:blood supply* / Q000000981:diagnostic imaging; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D055357:Uterine Artery Embolization / Q000009:adverse effects / Q000379:methods*; D014599:Uterus / Q000473:pathology* / Q000601:surgery
keywords: Pelvic arterial embolization; delivery; high-risk pregnancy; labour; maternal morbidity; postpartum hemorrhage; pregnancy complication