Abstract
Post-partum hemorrhage is an obstetrical emergency.
Pelvic artery embolisation offers an alternative to surgical intervention and increases
the rate of conservative treatment. The objective of this review was to study the
scientific literature on obstetrical outcomes following uterine-sparing arterial embolisation
performed for post-partum hemorrhage in a prior pregnancy.
A Medline and Sciencedirect search were performed in order to review all the French
and English reports about pregnancy following pelvic arteries embolisation for post-partum
hemorrhage.
Nineteen articles were identified and 13 were selected for inclusion. We have included
the fertility follow-up of a total of 168 women who underwent pelvic arteries embolisation
for post-partum hemorrhage. We highlight the clinical success of embolisation in 154
of the 168 patients (92%). Following the embolisation procedures, 7 hysterectomies
were required and 4 patients died. Two of the 4 deaths occurred in women who were
transferred from an outlying institution to a tertiary referral center.
In this population, 45 pregnancies were described. Among these pregnancies, 32 resulted
in live births (71%), 8 were miscarriages (18%) and 5 patients carried out voluntary
termination of pregnancy (11%). The cesarean section rate was 62%.
Post-partum hemorrhage occurred in 6 cases leading to 2 hysterectomies.
In conclusion, pelvic arterial embolisation offers a safe and conservative alternative
to surgical interventions for post-partum hemorrhage in well-selected patients desiring
to preserve future fertility.
Keywords
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Article info
Publication history
Published online: April 15, 2009
Accepted:
March 24,
2009
Received in revised form:
February 16,
2009
Received:
February 12,
2008
Identification
Copyright
© 2009 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
