Application of urgent transcatheter arterial embolization in intractable postpartum hemorrhage

Objective To investigate the efficacy and safety of emergency transcatheter arterial embolization (TAE) in the management of intractable postpartum hemorrhage. Methods Eighteen women with intractable postpartum hemorrhage underwent superselective catheterization to the bilateral internal iliac arteries or uterial arterial, and the TAE with gelfoam particles soaked in the Gentamycin sulfate was followed after the bleeding sources and causes was proved. Results Obstetrical bleeding were successfully controlled in all the 18 patients. The operation time of TAE lasted from 30 to 60 minutes, mean 45.2±4.8 minutes. Digital subtraction angiography showed diffuse extravasation of contrast agent in10 cases, bleeding from 4 vaginal arteries, 3 uterus arteries and one pudendal artery. All patients were followed up for 3 to 40 months. No severe complication of TAE occured. Menstruation resumed in all patients. Conclusion Emergency TAE is a safe and effective method in the control of intactable postpartum hemorrhage.