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Usefulness of Pelvic Artery Embolization in Cesarean Section Compared with Vaginal Delivery in 176 Patients

Authors
 Hyun Joo Lee  ;  Gyeong Sik Jeon  ;  Man Deuk Kim  ;  Sang Heum Kim  ;  Jong Tae Lee  ;  Min Jeong Choi 
Citation
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, Vol.24(1) : 103-109, 2013 
Journal Title
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY 
ISSN
 1051-0443 
Issue Date
2013
MeSH
Adult ; Cesarean Section/statistics & numerical data* ; Comorbidity ; Embolization, Therapeutic/statistics & numerical data* ; Female ; Hemostatics/therapeutic use* ; Humans ; Middle Aged ; Pelvis/blood supply* ; Postoperative Complications/epidemiology* ; Postpartum Hemorrhage/epidemiology* ; Postpartum Hemorrhage/therapy* ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Treatment Outcome
Keywords
Adult ; Cesarean Section/statistics & numerical data* ; Comorbidity ; Embolization, Therapeutic/statistics & numerical data* ; Female ; Hemostatics/therapeutic use* ; Humans ; Middle Aged ; Pelvis/blood supply* ; Postoperative Complications/epidemiology* ; Postpartum Hemorrhage/epidemiology* ; Postpartum Hemorrhage/therapy* ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Treatment Outcome
Abstract
PURPOSE: To evaluate the efficacy and safety of transcatheter arterial embolization of the pelvic arteries for the treatment of postpartum hemorrhage (PPH) associated with cesarean section compared with vaginal delivery. MATERIALS AND METHODS: A retrospective analysis of 176 patients undergoing transcatheter arterial embolization of the pelvic arteries for PPH from January 2006 through August 2011 was conducted at two institutions. The mean patient age was 33.9 years (range, 24-46 years). Data including delivery details, hematology and coagulation results, embolization details, and clinical outcomes were collected. Technical success was defined as cessation of bleeding on angiography or angiographically successful embolization of the bleeding artery. Clinical success was defined as the obviation of repeated embolization or surgical intervention. RESULTS: The technical success rate was 98.8% (n = 174), and the clinical success rate was 89.7% (n = 158). Among 176 patients, 71 had cesarean sections, and 105 underwent normal vaginal deliveries. Of the 105 patients who underwent normal vaginal deliveries, 11 (10.5%) required repeat embolization or surgical intervention. Of the 71 patients who had cesarean sections, 7 (9.8%) required repeat embolization or surgical intervention. The clinical success rate and complication rate were not related to the mode of delivery. All women resumed menses after transcatheter arterial embolization, and most (n = 125) described their menses as unchanged. Subsequent spontaneous pregnancies occurred in 13 women. CONCLUSIONS: The cesarean mode of delivery is not a predictor of poorer outcomes of transcatheter arterial embolization; however, further study is needed to clarify this relationship.
Full Text
http://www.sciencedirect.com/science/article/pii/S1051044312010184
DOI
10.1016/j.jvir.2012.09.029
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86400
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