Jean-Pierre Jacques Pelage MD, PhD, Presenter: Research grant, BioSphere Medical, Inc Consultant, BioSphere Medical, Inc Research grant, Biocompatibles International plc Research grant, Merit Medical Systems, Inc Consultant, Merit Medical Systems, Inc Research grant, Cook Group Incorporated Consultant, Cook Group Incorporated Research grant, Keocyt Medical Board, Keocyt Research grant, Terumo Corporation Consultant, Terumo Corporation

Audrey Fohlen, Abstract Co-Author: Nothing to Disclose

Olivier Limot MD, Abstract Co-Author: Nothing to Disclose

Olivier Le Dref MD, Abstract Co-Author: Nothing to Disclose

Penelop Labauge, Abstract Co-Author: Nothing to Disclose

Antoine Bourret, Abstract Co-Author: Nothing to Disclose

Arnaud Fauconnier, Abstract Co-Author: Nothing to Disclose

Vincent Le Pennec MD, Abstract Co-Author: Reviewer, Johnson and Johnson Educator, Cook Group Incorporated

To evaluate the role of round ligament artery embolization in patients with life-threatening post-partum hemorrhage. To review technique and results of round ligament artery embolization.

From 1997 to 2010, all cases of embolization of the round ligament artery in women with intractable post-partum hemorrhage were retrieved from our database. All women had embolization of the round ligament artery because of persistent or recurrent bleeding after embolization of the uterine or internal iliac arteries. The angiographic findings, technique of embolization and results were recorded.

A total of 15 women (mean age 28.8 years, range 23-35) were embolized. Ten (67%) patients had a caesarean section, 6 (40%) had hemodynamic instability and 6 (40%) had coagulation disorders. Hemoglobin levels ranged between 4.8 and 10.4 g/mL and 13 women required blood transfusion (2-10 units). Ten women had unilateral embolization and 5 had bilateral embolization (20 arteries embolized) with gelatine sponge torpedoes or microcoils. The round ligament artery originated from the external iliac artery or from the inferior epigastric artery in all women. Twelve (80%) women had embolization of the round ligament artery because of persistent external bleeding while 3 had a second procedure because of recurrent bleeding. Bleeding cessation was observed in 100% of cases but 2 women ultimately required hysterectomy. No complication was reported.

The round ligament artery may be a cause of persistent or recurrent bleeding in women with post-partum hemorrhage. Embolization is an effective and safe alternative to hysterectomy in most cases.

The round ligament artery may be a cause of persistent or recurrent bleeding in women with post-partum hemorrhage. Radiologists may be aware of the value of embolization.

Pelage, J, Fohlen, A, Limot, O, Le Dref, O, Labauge, P, Bourret, A, Fauconnier, A, Le Pennec, V, Embolization of the Round Ligament Artery in Women with Severe Postpartum Hemorrhage.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11013240.html