Pelvic arterial embolization for postpartum hemorrhage: long term results of a single center experience in 29,091 deliveries.

ABSTRACT

PURPOSE OF INVESTIGATION To evaluate the rate of all postpartum hemorrhages (PPHs) treated with uterine embolization in a third level delivery center. MATERIALS AND METHODS: Since January 2008 to March 2014, 29,091 deliveries were registered in the present hospital in Bergamo, Italy. Among these deliveries, 2,002 cases (6.8%) of PPHs occurred. Seventy-three patients with severe obstetric hemorrhage underwent uterine artery embolization (UAE) (47 cases, 1.61/1,000 deliveries) or hysterectomy (26 cases, 0.89/1,000 deliveries). All identified cases were followed up by telephone on January 2015 in order to evaluate long term results. RESULTS: Embolization was performed successfully in 45 patients (95.7%). Two women underwent total abdominal hysterectomy one patient for uterine atony and one for adherent placenta. In the follow up all the women interviewed reported the return of their menstrual cycle and 95.2% of women reported regular cycles. CONCLUSIONS: Embolization showed a success rate of 95.7%. For this reason, in the authors' opinion, it is the best choice as second line treatment of PPH, when patient is hemodynamically stable.