title: Bleeding after dilatation and curettage: the efficacy of transcatheter uterine artery embolisation.
abstract: OBJECTIVE
  To evaluate safety and clinical outcomes of uterine artery embolisation (UAE) for bleeding after dilatation and curettage (D&C) performed for abortion or termination.
  
  
  METHODS
  The outcomes were analysed in 11 patients who underwent UAE for bleeding after D&C for missed abortions (n=8), caesarean scar pregnancies (n=2), or planned termination (n=1) between October 2001 and December 2013. Angiograms and medical records were retrospectively reviewed in order to obtain the patients' baseline characteristics, technical/clinical success rate, complications, and follow-up data regarding menstruation.
  
  
  RESULTS
  Technical success, defined as successful catheterisation of both uterine arteries with embolisation to haemostasis, was 100%, whereas clinical success, defined as cessation of bleeding after the initial session of UAE and without the need for additional UAE or surgery for the purpose of haemostasis, was 81.8% (nine of 11). In the two patients with clinical failure due to recurrent vaginal bleeding after UAE, one patient underwent repeat UAE and showed a successful outcome, whilst the other patient required hysterectomy with pathological results of placenta increta. Two other patients underwent hysterectomy for placenta percreta or hydatidiform mole-mimicking remnant placenta. None of the patients included in the present series had procedure-related complications. Menstruation resumed in all eight patients with an intact uterus during the mean follow-up period.
  
  
  CONCLUSIONS
  UAE may be a safe and effective treatment for bleeding after D&C, especially for women who wish to preserve their fertility; however, hysterectomy may be indicated for patients with a placental abnormality.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea.
authors.forename: Y
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea. Electronic address: jhshin@amc.seoul.kr.
authors.forename: J H
authors.initials: JH
authors.lastname: Shin
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea.
authors.forename: H-K
authors.initials: HK
authors.lastname: Yoon
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea.
authors.forename: G-Y
authors.initials: GY
authors.lastname: Ko
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, South Korea.
authors.forename: H-S
authors.initials: HS
authors.lastname: Won
mesh_terms: D000028:Abortion, Induced; D000328:Adult; D004107:Dilatation and Curettage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000628:therapy*; D011247:Pregnancy; D011271:Pregnancy, Ectopic; D012189:Retrospective Studies; D016896:Treatment Outcome; D055357:Uterine Artery Embolization