Analysis of failed arterial embolization for postpartum hemorrhage.

So, Kyeong A; Oh, Yoon Kyung; Hwang, Hyo Soon; Hong, Hye Ri; Cho, Geum Joon; Oh, Min Jeong; Hur, Jun Yong

doi:2010.53.9.778

Obstet Gynecol Sci > Volume 53(9); 2010 > Article

Original Article

Korean Journal of Obstetrics & Gynecology 2010;53(9):778-786.
DOI: https://doi.org/10.5468/kjog.2010.53.9.778 Published online September 1, 2010.

Analysis of failed arterial embolization for postpartum hemorrhage.

Kyeong A So, Yoon Kyung Oh, Hyo Soon Hwang, Hye Ri Hong, Geum Joon Cho, Min Jeong Oh, Jun Yong Hur

Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea. joyfulplace@hanmail.net

Abstract

OBJECTIVE
To investigate what factors are associated with a failed arterial embolization for postpartum hemorrhage (PPH) and to attempt to estimate efficacy of arterial embolization. METHODS: Between 2004 and 2008, 60 patients at Korea University Medical Cencter underwent arterial embolization to control obstetrical hemorrhage. In all cases, arterial embolization was performed because of intractable hemorrhage unresponsive to conservative management. Medical records and angiographic results were reviewed. Arterial embolization failure was defined as the requirement for subsequent surgical procedure to control PPH with the procedure, and its results. RESULTS: Arterial embolization was attempted in 60 of deliveries. Failures occurred in 7 of 60 cases (11.7%) and in 4 of 7 cases (57.1%) of abnormal placentation (placenta previa totalis with or without placenta accrete or increta). Comparison of the failed and successful arterial embolization groups showed no differences in maternal characteristics, clinical status, and angiographic finding. Amount of total transfusion in failed arterial embolization group were larger than successful group although hemoglobin before embolization was not different. CONCLUSION: The only factor significantly associated with failed arterial embolization was an abnormal placentation. Arterial embolization is a safe and highly effective method to control PPH.

Key Words: Postpartum hemorrhage, Arterial embolization, Abnormal placentation