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Gynecol Obstet Fertil. 2008 Jul-Aug;36(7-8):714-20. doi: 10.1016/j.gyobfe.2008.06.004. Epub 2008 Jul 25.

[Current indications for uterine artery embolization to treat postpartum hemorrhage].

[Article in French]

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  • 1Service de radiologie, centre hospitalier de Poissy-Saint-Germain-en-Laye, 10 rue du Champ-Gaillard, Poissy cedex, France. jean-pierre.pelage@apr.aphp.fr

Abstract

Uterine artery embolization is an interventional radiology technique successfully used for more than 30 years in the management of gynecological or obstetrical hemorrhage. Precise indications for uterine artery embolization to treat postpartum hemorrhage have been recently published. Uterine artery embolization is indicated in case of uterine atony despite medical treatment particularly after vaginal delivery, in case of vaginal thrombus or cervical tear after failed surgical repair. Embolization can also be discussed in case of persistent hemorrhage after arterial ligation or hysterectomy. Finally, arterial embolization can be attempted in case of placenta accreta to avoid hysterectomy. In all situations, pluridisciplinary management of patients with involvement of interventional radiologists, anesthesiologists and obstetricians is mandatory. Early transportation of patients for embolization should be discussed taking into consideration time of onset of hemorrhage, expected transfer time and treatment options available on site. For validated indications, success rates of arterial embolization as high as 80% can be expected in experienced hands.

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PMID:
18656414
[PubMed - indexed for MEDLINE]
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