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Korean Journal of Obstetrics & Gynecology 2009;52(1):44-52.
Published online January 1, 2009.
Angiographic findings and effect of superselective embolization for early and late postpartum bleeding.
Jae Ryoung Kim, Young Kwon Cho, Hye Min Kim, Eun Joo Choi, Dae Woon Kim, Yong Soo Seo, Jin Yong Lee, Won Il Park
1Department of Obstetrics and Gynecology, School of Medicine, Eulji University, Seoul, Korea. pwi3110@eulji.ac.kr
2Department of Radiology, School of Medicine, Eulji University, Seoul, Korea.
Treatment of postpartum bleeding with uterine artery embolization has been well-described so far. However, angiographic differences between early and late postpartum bleeding has not been elucidated. The purpose of this study was to evaluate angiographic differences between early and late postpartum bleeding and therapeutic effect of superselective embolization. METHODS: Medical records and angiographic images of 12 patients (7 early and 5 late) with postpartum bleeding were evaluated. Timing of bleeding, mode of delivery, angiographic findings and treatment outcome were primary variables evaluated. RESULTS: Among 12 patients, 11 patients had been successfully treated with superselective embolization. One patient with amniotic fluid embolism and disseminated intravascular coagulation had expired. Among the early postpartum bleeding, uterine atony was found in every patients except post-cesarean hysterectomy cases. Pseudoaneurysm of uterine artery was found in all patients with late postpartum bleeding. CONCLUSION: Superselective embolization is an effective method to control postpartum bleeding. Pseudoaneurysm of uterine artery is a main cause of late postpartum bleeding.
Key Words: Postpartum hemorrhage, Therapeutic embolization, Angiography, Pseudoaneurysm

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