Hiroshi Kondo MD, Abstract Co-Author: Nothing to Disclose

Satoshi Goshima MD, PhD, Abstract Co-Author: Nothing to Disclose

Toshihisa Kojima, Abstract Co-Author: Nothing to Disclose

Haruo Watanabe MD, Abstract Co-Author: Nothing to Disclose

Hiroshi Kawada MD, Abstract Co-Author: Nothing to Disclose

Hiromi Ono MD, Presenter: Nothing to Disclose

Masayuki Kanematsu MD, Abstract Co-Author: Nothing to Disclose

Retrospective evaluation of pelvic transcatheter arterial embolization (TAE) for the treatment of severe post-partum hemorrhage.

This retrospective study had an institutional review board approval and written informed consent was waived. Forty consecutive patients (age 21-43, mean 33.1 yrs) who presented post-partum hemorrhage and underwent selective pelvic TAE to control severe hemorrhage between January 2006 and December 2010 were included. Among them, thirteen patients had a vaginal delivery and 21 had a caesarean section. The underlying causes presenting with post-partum hemorrhage were uterine atony (n = 26), vaginal injury (n = 3), ectopic pregnancy (n = 3), retained placenta (n = 3), placenta accrete (n = 2), inevitable abortion (n = 2) and uterine rupture (n = 1). The treatment efficacies, angiographic image findings, complications and post-procedural fertility were assessed.

All patients were successfully treated by selective TAE. The vessel most frequently embolized was the uterine artery. Conventional angiography revealed active contrast material extravasation in 35 patients (88%) and pseudoaneurysms in eleven patients (28%). There were no severe complications associated with TAE except for one patient who presented with intrauterine adhesion 15 months after the procedure. Among the 40 patients who underwent uterine arterial embolization, 19 patients were able to be followed for 5 to 60 months. All of them were confirmed their restart of normal menstruation. Pregnancies in three patients were confirmed after the procedure.

Pelvic TAE seemed to be the best therapeutic choice for severe post-partum hemorrhage.

Selective pelvic TAE is an effective and safe treatment for severe post-partum hemorrhage. This procedure would have patients avoid a high-risk surgery and retain fertility.

Kondo, H, Goshima, S, Kojima, T, Watanabe, H, Kawada, H, Ono, H, Kanematsu, M, Selective Pelvic Arterial Embolization in the Management of Postpartum Hemorrhage.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11003299.html