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Transcatheter arterial embolisation for the management of obstetric haemorrhage associated with placental abnormality in 40 cases

Authors
 Sook Min Hwang  ;  Gyeong Sik Jeon  ;  Man Deuk Kim  ;  Sang Heum Kim  ;  Jong Tae Lee  ;  Min Jeong Choi 
Citation
 European Radiology, Vol.23(3) : 766-773, 2013 
Journal Title
 European Radiology 
ISSN
 0938-7994 
Issue Date
2013
Abstract
OBJECTIVE: To evaluate pelvic artery embolisation (PAE) in the emergency management of intractable postpartum haemorrhage (PPH) associated with placenta accreta (PA). METHODS: Forty such patients (PAE for PPH/PA) were retrospectively reviewed. Medical records were reviewed regarding the delivery and PAE procedure. Follow-up gynaecological outcomes after PAE were obtained by telephone interviews. RESULTS: Technical success was achieved in all women (100 %). The initial clinical success rate was 82.5 % (33/40). Three patients with PA underwent hysterectomy after PAE failed to stop the bleeding within 24 h after the embolisation. The other three patients underwent re-embolisation (two patients underwent re-embolisation on the next day and one patient had undergone re-embolisation 6 h after the first embolisation), and bleeding had stopped eventually. The clinical success rate was 92.5 %. There were four cases of immediate complications, such as, pelvic pain, nausea and urticaria. There were three late minor complications, temporary menopause, but no late major complications. After the procedure, 35 patients resumed normal menstruation, including two uncomplicated pregnancies. One patient expired owing to disseminated intravascular coagulopathy and intracerebral haemorrhage, despite successful embolisation. CONCLUSION: PAE can be performed safely and effectively for patients with PPH and PA and can preserve the uterus in many patients.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86802
DOI
10.1007/s00330-012-2612-1
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김만득(Kim, Man Deuk)
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Full Text
http://link.springer.com/article/10.1007%2Fs00330-012-2612-1
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