Uterine Artery Embolization in Postpartum Hemorrhage

Background: Postpartum uterine hemorrhage is one of the most important causes of maternal mortality worldwide and as well in Egypt. Causes are variable most important of which are uterine atony and birth canal lacerations. Uterine artery embolization is very effective if local measures failed to stop bleeding Methods: In the period between January 2015 and November 2017, 75 women (mean age 26 years) with postpartum hemorrhage underwent embolization in Ain Shams University Hospitals after failure to achieve hemostasis after conservative treatments. Clinical success was defined as stabilization of vital data of the patient and obviation of hysterectomy. Gel foam hand cut pledges were the embolic agent used. Results: Bleeder whether extravasation or pseudoaneurysm could be identified angiographically in 32 patients. In 43 patients, no definite bleeder could be identified, so bilateral uterine artery embolization was done empirically. Clinical success rate was 80% (60 patients including 31 patients with angiographically identified bleeder). Hysterectomy was needed in 15 patients after rebleeding post-UAE. No major procedural-related complications were recorded. Conclusion: Transcatheter arterial Embolization of the uterine artery is a feasible treatment option in the management of postpartum bleeding with low rates of complications. Angiographic identification of the bleeding source was associated with higher clinical success rates decreasing the need for hysterectomies. Publication History Article published online: 11 May 2021 © 2018. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India