Uterine artery embolization versus cesarean hysterectomy in the management of postpartum hemorrhage

Abstract

Objective: The purpose of this study was to compare the efficacy and complications between cesarean hysterectomy and uterine artery embolization (UAE) in the management of postpartum bleeding.Material and methods: We analyzed the outcomes of 48 patients who underwent cesarean hysterectomy from October 2007 to January 2017, and 333 patients who underwent UAE for postpartum bleeding which was unresponsive to conservative management. We reviewed all medical records retrospectively, and assessed the length of hospital stay, amount of blood transfused, operative time, and all procedural-related complications.Results: There was a significant difference between the two groups in the mean hospital stay between the cesarean hysterectomy group and the UAE group (12.88 ± 15.37 days vs. 7.37 ± 15.92 days, respectively). The number of transfusions received by those in the cesarean hysterectomy group was larger than that in the UAE group, and this difference was also statistically significant (16.81 ± 11.23 pints vs. 5.59 ± 7.02 pints). The mean operative time of the UAE procedure was significantly shorter than the cesarean hysterectomy procedure (83 min vs. 179 min, respectively). We also closely compared complications during and after the procedures.Conclusion: We concluded that UAE is safer and more effective than cesarean hysterectomy for the management of postpartum hemorrhage unresponsive to conservative management.