Predictors of the success and failure of emergency pelvic artery embolisation for primary postpartum haemorrhage: a 12-year review
Singapore medical journal
;
: 272-278, 2017.
Article
in English
| WPRIM
| ID: wpr-296435
ABSTRACT
<p><b>INTRODUCTION</b>This study aimed to identify predictors of the outcome and clinical efficacy of emergency pelvic artery embolisation (PAE) for primary postpartum haemorrhage (PPH) and to assess the post-embolisation fertility of PAE patients in a regional hospital setting.</p><p><b>METHODS</b>A 12-year retrospective study of patients undergoing emergency PAE was conducted at a regional acute general hospital. Clinical and procedural parameters, clinical outcomes and post-embolisation pregnancy success rates were analysed.</p><p><b>RESULTS</b>There were 47,221 deliveries at the hospital during the study period, of which 33 patients required urgent PAE for primary PPH. The technical success rate of embolisation was 97.0% (n = 32). Clinically adequate haemostasis was achieved by a single embolisation procedure in 24 (72.7%) patients; the remaining eight eventually required surgery to achieve cessation of bleeding. Among the parameters studied, multivariate logistic regression analysis showed that pre-embolisation platelet count (p = 0.036) and maternal age (p = 0.019) were the only significant independent predictors of embolisation failure. Only two patients successfully conceived after PAE, although one of them had an ectopic pregnancy.</p><p><b>CONCLUSION</b>Emergency PAE is an effective measure to arrest life-threatening bleeding in patients with primary PPH. As low pre-embolisation platelet count and advanced maternal age are associated with higher odds of embolisation failure, careful post-embolisation monitoring may be required for such patients. Embolisation also allows subsequent pregnancy. However, further studies are required to assess the outcomes of post-embolisation pregnancies.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Type of study:
Observational study
/
Prognostic study
Language:
English
Journal:
Singapore medical journal
Year:
2017
Type:
Article
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