Transcatheter arterial embolization for treatment of intractable late postpartum hemorrhage

Abstract

Objective To evaluate the clinical value of transcatheter arterial embolization for treatment of intractable late postpartum hemorrhage.Methods Seventeen patients with intractable late postpartum hemorrhage were undertaken arterial embolization (9 to 31 days after parturition, average 21 days).All of the 17 patients were punctured the right femoral artery. Detected the bleeding artery by pelvic artery angiography, then superselectively catheterized into the leeding artery (uterine artery or the other pelvic artery), perfused broad-spectrum antibiotic into the bleeding artery first then embolized it with gelfoam particles immersed with broad-spectrum antibiotic. Embolized the bilateral artery when found the bleeding artery was uterine artery. Results The bleeding artery was unilateral uterine artery detected in 16 patients (left 9, right 7),the other one was the left internal pudendal artery. The catheterization successful rate and the bleeding artery hault rate were 100% respectively.The procedure lasted for 25-50 min(average 35 min).After the procedure, all of the 17 patients recovered gradually, no recurrent hemorrhage and no serious complications happened, menstruation of all the patients resumed during the follow-up period. Conclusion Transcatheter arterial embolization is a safe and effective way for treatment of intractable late postpartum hemorrhage, with it's advantages of mini-invasive, fast treating effect and less complications. Key words: Late postpartum hemorrhage; Arterial embolism; Uterus; Gelatin sponge