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

Sook Min Hwang, Gyeong Sik Jeon, ManDeuk Kim, Sang Heum Kim, Jong Tae Lee, Min Jeong Choi

Research output: Contribution to journalArticle

13 Citations (Scopus)

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. Key Points: • Pelvic artery embolisation (PAE) is an important therapeutic option for postpartum haemorrhage. • It seems safe and effective for PPH with placenta accreta (PA). • PAE preserves the uterus and does not impair subsequent menstruation. • PAE has few major complications.

Original languageEnglish
Pages (from-to)766-773
Number of pages8
JournalEuropean Radiology
Volume23
Issue number3
DOIs
Publication statusPublished - 2013 Jan 9

Fingerprint

Obstetrics
Placenta Accreta
Arteries
Postpartum Hemorrhage
Hemorrhage
Menstruation
Uterus
Pelvic Pain
Urticaria
Cerebral Hemorrhage
Menopause
Hysterectomy
Nausea
Medical Records
Emergencies
Interviews
Pregnancy

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Hwang, Sook Min ; Jeon, Gyeong Sik ; Kim, ManDeuk ; Kim, Sang Heum ; Lee, Jong Tae ; Choi, Min Jeong. / Transcatheter arterial embolisation for the management of obstetric haemorrhage associated with placental abnormality in 40 cases. In: European Radiology. 2013 ; Vol. 23, No. 3. pp. 766-773.
@article{b238b26b5b5c421488beb1515d8a0c07,
title = "Transcatheter arterial embolisation for the management of obstetric haemorrhage associated with placental abnormality in 40 cases",
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. Key Points: • Pelvic artery embolisation (PAE) is an important therapeutic option for postpartum haemorrhage. • It seems safe and effective for PPH with placenta accreta (PA). • PAE preserves the uterus and does not impair subsequent menstruation. • PAE has few major complications.",
author = "Hwang, {Sook Min} and Jeon, {Gyeong Sik} and ManDeuk Kim and Kim, {Sang Heum} and Lee, {Jong Tae} and Choi, {Min Jeong}",
year = "2013",
month = "1",
day = "9",
doi = "10.1007/s00330-012-2612-1",
language = "English",
volume = "23",
pages = "766--773",
journal = "European Radiology",
issn = "0938-7994",
publisher = "Springer Verlag",
number = "3",

}

Transcatheter arterial embolisation for the management of obstetric haemorrhage associated with placental abnormality in 40 cases. / Hwang, Sook Min; Jeon, Gyeong Sik; Kim, ManDeuk; Kim, Sang Heum; Lee, Jong Tae; Choi, Min Jeong.

In: European Radiology, Vol. 23, No. 3, 09.01.2013, p. 766-773.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Transcatheter arterial embolisation for the management of obstetric haemorrhage associated with placental abnormality in 40 cases

AU - Hwang, Sook Min

AU - Jeon, Gyeong Sik

AU - Kim, ManDeuk

AU - Kim, Sang Heum

AU - Lee, Jong Tae

AU - Choi, Min Jeong

PY - 2013/1/9

Y1 - 2013/1/9

N2 - 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. Key Points: • Pelvic artery embolisation (PAE) is an important therapeutic option for postpartum haemorrhage. • It seems safe and effective for PPH with placenta accreta (PA). • PAE preserves the uterus and does not impair subsequent menstruation. • PAE has few major complications.

AB - 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. Key Points: • Pelvic artery embolisation (PAE) is an important therapeutic option for postpartum haemorrhage. • It seems safe and effective for PPH with placenta accreta (PA). • PAE preserves the uterus and does not impair subsequent menstruation. • PAE has few major complications.

UR - http://www.scopus.com/inward/record.url?scp=84878559028&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878559028&partnerID=8YFLogxK

U2 - 10.1007/s00330-012-2612-1

DO - 10.1007/s00330-012-2612-1

M3 - Article

C2 - 23300034

AN - SCOPUS:84878559028

VL - 23

SP - 766

EP - 773

JO - European Radiology

JF - European Radiology

SN - 0938-7994

IS - 3

ER -