Is selective embolization of uterine arteries a safe alternative to hysterectomy in patients with postpartum hemorrhage?

Abstract

The purpose of this study was to evaluate the efficacy and safety of selective arterial embolization to control severe postpartum hemorrhage. Twenty-five women with intractable postpartum hemorrhage underwent uterine embolization in our institution during a 6-year period. Angiography revealed arterial extravasation in 13 patients (52%). Sixty-nine arteries were embolized. External bleeding resolved immediately or was markedly decreased in 24 women. In one patient, embolization failed to control the bleeding, and surgical treatment was required. No major complication of embolization therapy was observed. Ten women were followed up for an average of 2 years. Menstruation resumed in all patients, and one woman became pregnant. Embolization of acute postpartum hemorrhage is a safe and effective alternative to hysterectomy.