Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications

Philippe Soyer; Anthony Dohan; Raphael Dautry; Youcef Guerrache; Aude Ricbourg; Etienne Gayat; Mourad Boudiaf; Marc Sirol; Olivier Ledref

doi:10.1007/s00270-015-1054-y

Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications

Cardiovasc Intervent Radiol. 2015 Oct;38(5):1068-81. doi: 10.1007/s00270-015-1054-y. Epub 2015 Feb 13.

Authors

Philippe Soyer^{1

2}, Anthony Dohan^{3

4}, Raphael Dautry^{5

6}, Youcef Guerrache⁷, Aude Ricbourg⁸, Etienne Gayat^{9

10}, Mourad Boudiaf¹¹, Marc Sirol¹², Olivier Ledref¹³

Affiliations

¹ Department of Abdominal and Interventional Imaging, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France. philippe.soyer@lrb.aphp.fr.
² Diderot-Paris 7, Université-Sorbonne Paris-Cité, 10 Avenue de Verdun, 75010, Paris, France. philippe.soyer@lrb.aphp.fr.
³ Department of Abdominal and Interventional Imaging, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France. anthony.dohan@lrb.aphp.fr.
⁴ Diderot-Paris 7, Université-Sorbonne Paris-Cité, 10 Avenue de Verdun, 75010, Paris, France. anthony.dohan@lrb.aphp.fr.
⁵ Department of Abdominal and Interventional Imaging, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France. raphael_dautry@yahoo.fr.
⁶ Diderot-Paris 7, Université-Sorbonne Paris-Cité, 10 Avenue de Verdun, 75010, Paris, France. raphael_dautry@yahoo.fr.
⁷ Department of Abdominal and Interventional Imaging, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France. docyoucef05@yahoo.fr.
⁸ Department of Obstetrics and Gynecology, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France. aude.ricbourg@lrb.aphp.fr.
⁹ Diderot-Paris 7, Université-Sorbonne Paris-Cité, 10 Avenue de Verdun, 75010, Paris, France. etienne.gayat@lrb.aphp.fr.
¹⁰ Department of Anesthesiology, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France. etienne.gayat@lrb.aphp.fr.
¹¹ Department of Abdominal and Interventional Imaging, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France. mourad.boudiaf@lrb.aphp.fr.
¹² Department of Abdominal and Interventional Imaging, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France. marc.sirol@lrb.aphp.fr.
¹³ Department of Abdominal and Interventional Imaging, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France. olivier.ledref@lrb.aphp.fr.

PMID: 25677130
DOI: 10.1007/s00270-015-1054-y

Abstract

Postpartum hemorrhage (PPH) is a potentially life-threatening condition, which needs multidisciplinary management. Uterine atony represents up to 80 % of all causes of PPH. Transcatheter arterial embolization (TAE) has now a well-established role in the management of severe PPH. TAE allows stopping the bleeding in 90 % of women with severe PHH, obviating surgery. Pledgets of gelatin sponge as torpedoes are commonly used for safe TAE, and coils, glue, and microspheres have been primarily used in specific situations such as arterial rupture, pseudoaneurysm, and arteriovenous fistula. TAE is a minimally invasive procedure with a low rate of complications, which preserves future fertility. Knowledge of causes of PPH, potential risks, and limitations of TAE is essential for a timely decision, optimizing TAE, preventing irreversible complications, avoiding hysterectomy, and ultimately preserving fertility.

Keywords: Arterial embolization; Emergency; Pelvic embolization; Postpartum hemorrhage; Review.

Publication types

Review

MeSH terms

Embolization, Therapeutic*
Female
Humans
Postpartum Hemorrhage / therapy*
Treatment Outcome