Efficacy and safety of uterine artery embolization in the management of postpartum hemorrhage.

Abstract

Objective: To demonstrate the safety and efficacy of endovascular treatment in postpartum hemorrhage (PPH).

Material and methods: We conducted a retrospective observational study with a sample from our Interventional Vascular Radiology unit, from 2004 to 2020. Patients who developed postpartum hemorrhage treated by arterial embolization were selected. Inclusion criteria were established to standardize the study group. Variables for the study of the efficacy and safety of the technique are defined.

Results: The final sample of the study was 56 patients. Technical success turned was 100%, while clinical success after endovascular treatment was 92.85%, with a hysterectomy rate due to failed arterial embolization of 7.14%, with uterine rupture observed in 3 cases as a cause of PPH and another case was a placenta accreta. No technique-related mortality was recorded. The rate of periprocedural complications was 3.56%, the same as that of late complications. No major or infectious complications were recorded. The pregnancy rate after embolization was 23.52%.

Conclusions: Selective arterial embolization of the uterine artery in PPH is a safe and effective procedure, being a therapeutic alternative in the face of failure of pharmacological and obstetric management, with preservation of fertility.