Obstetric and gynecologic vascular interventions

The applicability of nonsurgical treatments for benign diseases continues to be the focus of investigations in obstetric and gynecologic diseases. An understanding of the pelvic vascular anatomy is mandatory for safe and effective vascular interventions. Massive vaginal bleeding resulting from postpartum hemorrhage, uterine arteriovenous malformation, and uterine cervical carcinoma can be managed by endovascular treatment. Uterine artery embolization (UAE) has emerged as a viable treatment option for patients with symptomatic fibroids. Recovery and time to return to work is weeks shorter than recovery from surgery. UAE is also effective in the management of symptomatic adenomyosis as the primary treatment and as an alternative to hysterectomy despite the possibility of symptom recurrence. Pelvic congestion syndrome as a source of chronic pelvic pain can be effectively treated with embolization of the ovarian vein using coils with or without sclerosing agents.