Abstract
This study aimed to determine the rate of repeat uterine artery embolization (UAE) in women with a previous UAE. Study data were collected from the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service for 2009–2013. We enrolled women who had a first delivery in 2009 and a second delivery between 2010 and 2013. Among 226,408 women who had a first delivery in 2009, 296 underwent UAE. A total of 127,506 women had a second delivery between 2010 and 2013. Of 296 women who underwent UAE after the first delivery, 94 had a second delivery between 2010 and 2013. Women with a previous UAE had a higher rate of UAE at the second delivery than women without a previous UAE. Multivariate adjusted analysis showed that a UAE at the first delivery increased the rate of UAE at the second delivery (odds ratio 25.56, 95% confidence interval 9.86–66.23). Women with a previous UAE should be appropriately counseled and monitored for the need for a repeat UAE.
Highlights
Postpartum hemorrhage (PPH) is dangerous, and is a leading cause of maternal morbidity and mortality [1,2,3]
The rate of uterine artery embolization (UAE) for postpartum hemorrhage (PPH) has increased [8], and subsequent pregnancy outcomes are of concern in treated women
We identified all women who delivered and women who underwent peripartum hysterectomy (PH) or UAE during the study period by using the International Classification of Diseases, tenth Revision (ICD-10) diagnosis and procedure codes
Summary
Postpartum hemorrhage (PPH) is dangerous, and is a leading cause of maternal morbidity and mortality [1,2,3]. In cases of uncontrolled PPH despite medical treatment, conservative surgical management can be tried. Among several treatment options for uncontrolled PPH, uterine artery embolization (UAE) is a safe and minimally invasive procedure with a greater than 90% success rate for adequate hemostasis [4,5,6]. A major advantage of UAE in the treatment of PPH is its potential to preserve fertility by avoiding hysterectomy [7]. The rate of UAE for PPH has increased [8], and subsequent pregnancy outcomes are of concern in treated women. Several studies have evaluated the long-term effect of UAE on fertility and future pregnancy outcomes, and found that these women can conceive and have
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