Efficacy of pelvic artery embolisation for severe postpartum hemorrhage.

Spreu, Annette; Abgottspon, F; Baumann, Marc Ulrich; Kettenbach, Joachim; Surbek, Daniel (2017). Efficacy of pelvic artery embolisation for severe postpartum hemorrhage. Archives of gynecology and obstetrics, 296(6), pp. 1117-1124. Springer 10.1007/s00404-017-4554-y

[img] Text
s00404-017-4554-y 28993967.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (537kB) | Request a copy

PURPOSE The purpose of our study was to evaluate the outcome of selective pelvic arterial embolisation (PAE) in women with severe postpartum hemorrhage (PPH). METHODS We performed a retrospective, controlled, single-center cohort study. A total of 16 consecutive women with PPH who underwent therapeutic PAE were included. As historical control group, we included 22 women with similar severity of PPH who were managed without PAE. Outcome measures included necessity of surgical interventions such as postpartum hysterectomy and laparotomy after vaginal delivery, the amount of red blood cell transfusions, and hematologic findings after the procedure. RESULTS PAE was successful in stopping PPH and preserving the uterus in all 16 women in the study group. No woman in the PAE group required a postpartum hysterectomy, whereas postpartum hysterectomy was unavoidable in two women in the control group. Laparotomy after vaginal delivery was necessary in two women of the group without embolisation. Hematologic parameters after the treatment were better in the PAE group than in the control group, although these differences were only in part statistically significant. There were no unwarranted effects of PAE identifiable in the study group. CONCLUSION This is the first controlled study assessing the efficacy of PAE for the treatment of PPH. Our data suggest that PAE is effective for the treatment of severe PPH. In view of the lack of complications and unwarranted effects, clinical use of PAE in severe PPH seems justified, particularly in view of the life-threatening condition and the potential to preserve fertility in affected patients. Further evidence from well-designed prospective randomized-controlled trials would be nevertheless desirable in the future.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Baumann, Marc Ulrich; Kettenbach, Joachim and Surbek, Daniel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0932-0067

Publisher:

Springer

Language:

English

Submitter:

Monika Zehr

Date Deposited:

14 Feb 2018 14:56

Last Modified:

29 Oct 2019 18:02

Publisher DOI:

10.1007/s00404-017-4554-y

PubMed ID:

28993867

Uncontrolled Keywords:

Laparotomy after vaginal delivery Postpartum hemorrhage Postpartum hysterectomy Selective pelvic arterial embolisation

BORIS DOI:

10.7892/boris.110880

URI:

https://boris.unibe.ch/id/eprint/110880

Actions (login required)

Edit item Edit item
Provide Feedback