Clinical analysis of pelvic arterial embolization for treatment of primary postpartum hemorrhage

Abstract

Objective To evaluate the safety and efficacy of pelvic arterial embolization (PAE) for treatment of primary postpartum hemorrhage (PPH), and to determine the factors associated with clinical outcomes. Methods A total of 25 patients who underwent PAE for primary PPH were retrospectively analyzed. Mode of delivery, causes of primary PPH, detailed laboratory and treatment records, and clinical outcomes were recorded. Univariate and multivariate analyses were performed to determine the factors related to clinical outcomes. Results Clinical success was achieved in 23 patients (23/25, 92.00%), the other 2 patients underwent repeat PAE. Overall bleeding control was achieved in 96.00% (24/25) patients, the other was died of hypovolemic shock after second session of PAE. Of the 23 patients with long-term follow-up, 23 (100%) restarted regular menstruation, and 4 became pregnant. Univariate analysis showed that caesarean section delivery, associated disseminated intravascular coagulation (DIC), and massive transfusion more than 10 red blood cell units were related to a high rate of clinical failure. Multivariate analysis showed that associated DIC and massive transfusion were significantly related to clinical failure. Conclusions PAE for primary PPH is safe and effective, with bleeding control successfully after PAE observed in 96.00% of patients. Patients with associated DIC and massive transfusion were likely to need careful observation after PAE. Key words: Embolization, therapeutic; Primary postpartum hemorrhage