title: Efficacy of Prophylactic Uterine Artery Embolization before Obstetrical Procedures with High Risk for Massive Bleeding.
abstract: To evaluate the safety and efficacy of prophylactic uterine artery embolization (UAE) before obstetrical procedures with high risk for massive bleeding.
  
  
  
  A retrospective review of 29 female patients who underwent prophylactic UAE from June 2009 to February 2014 was performed. Indications for prophylactic UAE were as follows: dilatation and curettage (D&C) associated with ectopic pregnancy (cesarean scar pregnancy, n = 9; cervical pregnancy, n = 6), termination of pregnancy with abnormal placentation (placenta previa, n = 8), D&C for retained placenta with vascularity (n = 5), and D&C for suspected gestational trophoblastic disease (n = 1). Their medical records were reviewed to evaluate the safety and efficacy of UAE.
  
  
  
  All women received successful bilateral prophylactic UAE followed by D&C with preservation of the uterus. In all patients, UAE followed by obstetrical procedure prevented significant vaginal bleeding on gynecologic examination. There was no major complication related to UAE. Vaginal spotting continued for 3 months in three cases. Although oligomenorrhea continued for six months in one patient, normal menstruation resumed in all patients afterwards. During follow-up, four had subsequent successful natural pregnancies. Spontaneous abortion occurred in one of them during the first trimester.
  
  
  
  Prophylactic UAE before an obstetrical procedure in patients with high risk of bleeding or symptomatic bleeding may be a safe and effective way to manage or prevent serious bleeding, especially for women who wish to preserve their fertility.
authors.affiliation: Department of Radiology, Asan Medical Center, Ulsan University College of Medicine, Seoul 05505, Korea.
authors.forename: Heung Kyu
authors.initials: HK
authors.lastname: Ko
authors.affiliation: Department of Radiology, Asan Medical Center, Ulsan University College of Medicine, Seoul 05505, Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Shin
authors.affiliation: Department of Radiology, Asan Medical Center, Ulsan University College of Medicine, Seoul 05505, Korea.
authors.forename: Gi Young
authors.initials: GY
authors.lastname: Ko
authors.affiliation: Department of Radiology, Asan Medical Center, Ulsan University College of Medicine, Seoul 05505, Korea.
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Gwon
authors.affiliation: Department of Radiology, Asan Medical Center, Ulsan University College of Medicine, Seoul 05505, Korea.
authors.forename: Jin Hyung
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Asan Medical Center, Ulsan University College of Medicine, Seoul 05505, Korea.
authors.forename: Kichang
authors.initials: K
authors.lastname: Han
authors.affiliation: Department of Obstetrics and Gynecology, Asan Medical Center, Ulsan University College of Medicine, Seoul 05505, Korea.
authors.forename: Shin-Wha
authors.initials: SW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000792:Angiography; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D008875:Middle Aged; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000601:surgery; D012189:Retrospective Studies; D055357:Uterine Artery Embolization; D014592:Uterine Hemorrhage / Q000517:prevention & control*; D055815:Young Adult
keywords: Bleeding; Obstetrical procedure; Prophylaxis; Uterine artery embolization