Korean J Obstet Gynecol.  2010 Sep;53(9):778-786. 10.5468/kjog.2010.53.9.778.

Analysis of failed arterial embolization for postpartum hemorrhage

• So KA
• Oh YK
• Hwang HS
• Hong HR
• Cho GJ
• Oh MJ
• Hur JY

• KMID: 2077995
• DOI: http://doi.org/10.5468/kjog.2010.53.9.778

Abstract

OBJECTIVE
To investigate what factors are associated with a failed arterial embolization for postpartum hemorrhage (PPH) and to attempt to estimate efficacy of arterial embolization.
METHODS
Between 2004 and 2008, 60 patients at Korea University Medical Cencter underwent arterial embolization to control obstetrical hemorrhage. In all cases, arterial embolization was performed because of intractable hemorrhage unresponsive to conservative management. Medical records and angiographic results were reviewed. Arterial embolization failure was defined as the requirement for subsequent surgical procedure to control PPH with the procedure, and its results.
RESULTS
Arterial embolization was attempted in 60 of deliveries. Failures occurred in 7 of 60 cases (11.7%) and in 4 of 7 cases (57.1%) of abnormal placentation (placenta previa totalis with or without placenta accrete or increta). Comparison of the failed and successful arterial embolization groups showed no differences in maternal characteristics, clinical status, and angiographic finding. Amount of total transfusion in failed arterial embolization group were larger than successful group although hemoglobin before embolization was not different.
CONCLUSION
The only factor significantly associated with failed arterial embolization was an abnormal placentation. Arterial embolization is a safe and highly effective method to control PPH.

Keyword

Postpartum hemorrhage; Arterial embolization; Abnormal placentation

MeSH Terms

Hemoglobins
Hemorrhage
Humans
Korea
Medical Records
Placenta
Placentation
Postpartum Hemorrhage
Postpartum Period
Hemoglobins

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