title: Value of Round Ligament Artery Embolization in the Management of Postpartum Hemorrhage.
abstract: OBJECTIVE
  To evaluate the feasibility and efficacy of embolization of the round ligament arteries in the management of postpartum hemorrhage.
  
  
  METHODS
  Eleven women (mean age, 31 y) underwent round ligament artery because of persistent or recurrent hemorrhage after initial uterine or internal iliac artery embolization.
  
  
  RESULTS
  A total of 16 round ligament arteries were embolized. The round ligament artery arose from the inferior epigastric artery in 11 cases (69%) and directly from the external iliac artery in 5 (31%). Embolization was performed with calibrated microspheres in 7 women (63%) and gelatin sponge pledgets in 4 (37%). Coils were used in addition to gelatin sponge pledgets in 3 patients. Hemostasis was achieved in 10 patients (91%), and 1 required additional conservative surgery. The mean hemoglobin level before embolization was 7.2 g/dL ± 1 and increased significantly on day 1 after embolization (10.3 g/dL ± 1.0; P < .05). No procedure-related complication was reported. The mean hospital stay was 5.6 days ± 2. Two patients had further pregnancies 13 and 14 months after embolization.
  
  
  CONCLUSIONS
  Selective embolization of the round ligament artery is a safe and effective treatment for obstetric hemorrhage. It should be considered in cases of persistent or recurrent bleeding after initial uterine or internal iliac artery embolization.
authors.affiliation: Department of Diagnostic Imaging and Interventional Radiology, Centre Hospitalier Universitaire de Caen, Normandie University, Caen, France.
authors.forename: Grégoire
authors.initials: G
authors.lastname: Leleup
authors.affiliation: Department of Diagnostic Imaging and Interventional Radiology, Centre Hospitalier Universitaire de Caen, Normandie University, Caen, France; Imagerie et Stratégie Thérapeutique des Pathologies Cérébrales et Tumorales, Normandie University, UNICAEN, CEA, Centre National de la Recherche Scientifique, ISTCT, Caen, Caen, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Fohlen
authors.affiliation: Department of Body and Interventional Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 965, Université Paris-Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Anthony
authors.initials: A
authors.lastname: Dohan
authors.affiliation: Department of Radiology, Centre Hospitalier de Poissy, Poissy, France.
authors.forename: Lara
authors.initials: L
authors.lastname: Bryan-Rest
authors.affiliation: Department of Diagnostic Imaging and Interventional Radiology, Centre Hospitalier Universitaire de Caen, Normandie University, Caen, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Le Pennec
authors.affiliation: Department of Radiology, Centre Hospitalier de Poissy, Poissy, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Limot
authors.affiliation: Department of Body and Interventional Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 965, Université Paris-Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Le Dref
authors.affiliation: Department of Body and Interventional Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 965, Université Paris-Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Soyer
authors.affiliation: Department of Diagnostic Imaging and Interventional Radiology, Centre Hospitalier Universitaire de Caen, Normandie University, Caen, France; Imagerie et Stratégie Thérapeutique des Pathologies Cérébrales et Tumorales, Normandie University, UNICAEN, CEA, Centre National de la Recherche Scientifique, ISTCT, Caen, Caen, France. Electronic address: pelage-jp@chu-caen.fr.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pelage
mesh_terms: D000328:Adult; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D007083:Iliac Artery; D006473:Postpartum Hemorrhage / Q000628:therapy*; D000069590:Round Ligaments / Q000098:blood supply*; D016896:Treatment Outcome; D055357:Uterine Artery Embolization