Study on treatment of postpartum hemorrhage with urgent interventional embolization / 介入放射学杂志

ABSTRACT

Objective To evaluate urgent selective arterial embolization to treat massive postpartum hemorrhage. Methods Twenty seven patients with ages of 21～53 years undengoing severe postpartunm hemorrhage, were due to centrol placenta previa, uterine atony, birth canal trauma, placenta accretio, cervical pregnancy etc. All of the patients had lost a volume of blood about 1 000ml to 5 000ml while the hemorrhage could not be controlled with vaginal packing and administration of uterotonic drugs. Urgent hemostatic embolization was performed for them. After angiography, super selective catheterization was performed for bilateal anterior division of internal iliac branch of uterine arteries and embolized with Gelfoam particles. Results Catheterization success rate was 96.3%. Angiography showed ectopic uterine artery in one case. Immediate block of hemorrhage took place in 22 cases and gradual hemostasis appeared in 4 cases, the efficacy rate was 96.3%. The one with ectopic uterine artery was operated upon to ablate the uterus. 11 patients with (bleeding) shock and 8 patients with DIC were all saved. Conclusions Urgent arterial embolization is an ideal method for treating life threatening postpartum hemorrhage. The procedure saves the maternal uterus and is also effective for postpartum DIC.