Angiographic embolization for obstetrical hemorrhage: effectiveness and follow-up outcome of fertility

Background. This study was undertaken to describe the results of angiographic embolization for obstetrical hemorrhage and the follow-up outcome of fertility. Methods. Consecutive patients who received angiographic embolization for the management of obstetrical hemorrhage at a single tertiary center were included in this study. Medical records were reviewed to collect the clinical data and details on the procedure. Patients were interviewed by telephone to obtain the long-term outcomes for complications, menstruation, desire for conception, and subsequent pregnancies. Results. Embolization was successful in 42 (86%) of 49 patients with obstetrical hemorrhage resulting from various causes. The main cause of hemorrhage was uterine atony (n = 24). The success rate was significantly lower in cases with abnormal placentation than in other causes of hemorrhage (p <0.05). The procedure took an average of 45.6 min (range, 20-120 min). There were no major complications related to the procedure. We were able to follow-up 48 patients. Among 37 patients with preserved uteri, menstruation resumed spontaneously in 36 patients. Nine patients became pregnant, of which six gave birth to healthy babies and three ended in early miscarriage. Conclusions. Angiographic embolization is an effective noninvasive method for the management of obstetrical hemorrhage and a useful technique for preserving fertility.