Uterine Artery Embolization Successfully Controls Postpartum Hemorrhage

Better coagulation status prior to embolization tied to better hemorrhage control
Uterine Artery Embolization Successfully Controls Postpartum Hemorrhage
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Medically Reviewed By:
Mark Arredondo, M.D.

MONDAY, March 25, 2024 (HealthDay News) -- Uterine artery embolization (UAE) has a high rate of success in controlling postpartum hemorrhage (PPH), according to a study presented at the annual meeting of the Society of Interventional Radiology, held from March 23 to 28 in Salt Lake City.

Younes Jahangiri, M.D., from Corewell Health West Michigan in Grand Rapids, and colleagues evaluated short- and long-term outcomes of UAE for treatment of uncontrolled PPH among 66 patients treated from January 2014 to December 2022.

The researchers found that the median time between PPH onset and UAE was four hours and 18 minutes (range, 11 minutes to 15 days, 23 hours, and 49 minutes). Median pre-embolization blood loss was 2,760 mL, with pre-embolization transfusion administered in 54 of 66 patients (82 percent). Embolization had a median duration of 67 minutes (range, 31 to 222 minutes). A lower international normalized ratio and higher fibrinogen levels prior to embolization were associated with better hemorrhage control. No deaths occurred during or after embolization, but four patients with unsuccessful hemorrhage control subsequently underwent total abdominal hysterectomy. African-American women and those with higher pre-embolization blood loss had a higher risk for postembolization syndrome, including fever or abdominal pain, which occurred in 36 percent of cases.

"Based on these findings, we would encourage obstetricians to involve interventional radiologists early, to be ready to perform UAE if more conservative approaches are not managing postpartum hemorrhage," senior author James Morrison, M.D., from the Michigan State University College of Human Medicine in Grand Rapids, said in a statement.

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