The Modern Role of Arterial Embolization in the Management of Postpartum Hemorrhage

Abstract

Objective: To review published studies of transcatheter arterial embolization in the management of postpartum hemorrhage. Material(s) and Method(s): The English-language literature from 1979 through 2001 of Medline was searched using the terms“postpartum hemorrhage”and“arterial embolization”. All relevant English-language clinical research articles retrieved were reviewed which regard to the current obstetric indications for transcatheter arterial embolization, types of embolotherapy, technical considerations, immediate success rates and efficacy, causes of failure, complications, and outcomes. Result(s): Our comprehensive literature review and clinical experience suggest that transcatheter arterial embolization is a safe and effective means of controlling postpartum, postcesarean, and posthysterectomy bleeding; it should be used before surgical treatment of postpartum hemorrhage. Benefits of transcatheter arterial embolization for patients include low complication rates, avoidance of surgical risks, maintenance of reproductive ability, and shorter hospitalization times. It was successful in controlling postpartum hemorrhage in 94% of cases reviewed. Conclusion(s): It is our strong belief that transcatheter arterial embolization is underused in Taiwan, and this literature review demonstrates that transcatheter arterial embolization can play a role as a modern alternative as it is a highly effective, relatively noninvasive method of treating postpartum hemorrhage.