Recurrent Bleeding Within 24 Hours After Uterine Artery Embolization for Severe Postpartum Hemorrhage: Are There Predictive Factors?
- Gabriel Montpied Hospital, CHU Clermont-Ferrand, Department of Radiology (France)
- Gabriel Montpied Hospital, Department of Public Health (France)
- Gabriel Montpied Hospital, Department of Gynecology (France)
Purpose: To retrospectively identify predictive factors of recurrent bleeding within 24 h after uterine artery embolization (UAE) for postpartum hemorrhage (PPH). Materials and Methods: A total of 194 patients underwent UAE for PPH between August 1999 and April 2009 at our institution. Twelve patients experienced recurrent bleeding within the next 24 h; a second attempt at UAE was thus necessary, which was successful in 10 cases. In two cases, hemostatic hysterectomy was performed. Epidemiological, gynecological-obstetrical, anatomic, and biological data were analyzed. Results: Complete data were available for 148 of the 194 (76%) included patients. Sixty-four (43%) were primiparous, 18 (12.2%) had a placenta accreta, 21 (14%) had a coagulopathy, and 28 (18.9%) had an anatomic variant of the uterine arterial vasculature. Mean age and pregnancy term were similar in both recurring and nonrecurrent bleeding groups. After multivariate analysis, three criteria emerged as risk factors of recurrent bleeding: primiparity (10 patients, 83%; odds ratio [OR] = 18.84; P = 0.014), coagulation disorders (6 patients, 50%; OR = 12.08; P = 0.006), and anatomic variant of the uterine arterial vasculature (28 patients; OR = 9.83; P = 0.003). Conclusions: earch for uterine collaterals must be performed before UAE for PPH. Primiparity and coagulation disorders increase the risk of recurrent bleeding after UAE for PPH.
- OSTI ID:
- 21608537
- Journal Information:
- Cardiovascular and Interventional Radiology, Vol. 35, Issue 3; Other Information: DOI: 10.1007/s00270-011-0181-3; Copyright (c) 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
- Country of Publication:
- United States
- Language:
- English
Similar Records
Prophylactic Occlusion Balloon Placement in the Abdominal Aorta Combined with Uterine or Ovarian Artery Embolization for the Prevention of Cesarean Hysterectomy Due to Placenta Accreta: A Retrospective Study
Transcatheter Arterial Embolization for Primary Postpartum Hemorrhage: Predictive Factors of Need for Embolic Material Conversion of Gelatin Sponge Particles to N-Butyl Cyanoacrylate