Hypogastric Arterial Selective and Superselective Embolization for Severe Postpartum Hemorrhage: A Retrospective Review of 36 Cases

Boulleret, C; Chahid, T; Gallot, D; Mofid, R; Tran Hai, D; Ravel, A; Garcier, J M; Lemery, D; Boyer, L

doi:10.1007/S00270-003-2698-6

Title: Hypogastric Arterial Selective and Superselective Embolization for Severe Postpartum Hemorrhage: A Retrospective Review of 36 Cases

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Abstract

We report on embolization in 36 cases of postpartum hemorrhage (PPH). The 36 patients with severe PPH, including one patient who had undergone an emergency hysterectomy, were transferred to the regional interventional vascular radiology unit in a mean time of 6 hours 12 min. Bilateral occlusion of the anterior trunk of the hypogastric arteries was carried out using gelatin sponge. Immediate success was achieved in all cases. In 3 cases, however, a second embolization was necessary before day 2. In 17%, complementary nonvascular surgery was performed. Complications included one puncture site false aneurysm treated by compression, two cases of regressive lower limb paraesthesia, one femoral vein thrombosis, and nonsignificant puncture site hematomas (19.5%). Long-term follow-up was conducted in 23 patients: 91% resumed regular menstrual cycles, 8.7% dysmenorrhea. New pregnancy occurred in 13% (two full-term pregnancies and one voluntary termination). Immediate efficacy, low morbidity and preservation of fertility make embolization the technique of choice for severe PPH.

Authors:

Boulleret, C ^[1]; Chahid, T ^[2]; Gallot, D ^[1]; Mofid, R; Tran Hai, D; Ravel, A; Garcier, J M ^[2]; Lemery, D ^[1]; Boyer, L ^[2]

Service de Gynecologie-Obstetrique, Clermont-Ferrand University Hospital, BP69 63003 (France)
Service de Radiologie, Clermont-Ferrand University Hospital, BP69 63003, Clermont-Ferrand (France)

Publication Date:: Sun Aug 15 00:00:00 EDT 2004

OSTI Identifier:: 21088254

Resource Type:: Journal Article

Journal Name:: Cardiovascular and Interventional Radiology

Additional Journal Information:: Journal Volume: 27; Journal Issue: 4; Other Information: DOI: 10.1007/s00270-003-2698-6; Copyright (c) 2004 Springer-Verlag; Article Copyright (c) 2004 Springer-Verlag New York, Inc.; www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551

Country of Publication:: United States

Language:: English

Subject:: 62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; BIOMEDICAL RADIOGRAPHY; FERTILITY; GELATIN; HEMATOMAS; HEMORRHAGE; LIMBS; MENSTRUAL CYCLE; PATIENTS; REVIEWS; THROMBOSIS; VEINS

Citation Formats


                    Boulleret, C, Chahid, T, Gallot, D, Mofid, R, Tran Hai, D, Ravel, A, Garcier, J M, Lemery, D, and Boyer, L. Hypogastric Arterial Selective and Superselective Embolization for Severe Postpartum Hemorrhage: A Retrospective Review of 36 Cases.  United States: N. p., 2004. 
        Web.  doi:10.1007/S00270-003-2698-6.

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                    Boulleret, C, Chahid, T, Gallot, D, Mofid, R, Tran Hai, D, Ravel, A, Garcier, J M, Lemery, D, & Boyer, L. Hypogastric Arterial Selective and Superselective Embolization for Severe Postpartum Hemorrhage: A Retrospective Review of 36 Cases.  United States.  https://doi.org/10.1007/S00270-003-2698-6

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                    Boulleret, C, Chahid, T, Gallot, D, Mofid, R, Tran Hai, D, Ravel, A, Garcier, J M, Lemery, D, and Boyer, L. 2004.  
        "Hypogastric Arterial Selective and Superselective Embolization for Severe Postpartum Hemorrhage: A Retrospective Review of 36 Cases".  United States.  https://doi.org/10.1007/S00270-003-2698-6.

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@article{osti_21088254,

  title        = {Hypogastric Arterial Selective and Superselective Embolization for Severe Postpartum Hemorrhage: A Retrospective Review of 36 Cases},

  author       = {Boulleret, C and Chahid, T and Gallot, D and Mofid, R and Tran Hai, D and Ravel, A and Garcier, J M and Lemery, D and Boyer, L},

  abstractNote = {We report on embolization in 36 cases of postpartum hemorrhage (PPH). The 36 patients with severe PPH, including one patient who had undergone an emergency hysterectomy, were transferred to the regional interventional vascular radiology unit in a mean time of 6 hours 12 min. Bilateral occlusion of the anterior trunk of the hypogastric arteries was carried out using gelatin sponge. Immediate success was achieved in all cases. In 3 cases, however, a second embolization was necessary before day 2. In 17%, complementary nonvascular surgery was performed. Complications included one puncture site false aneurysm treated by compression, two cases of regressive lower limb paraesthesia, one femoral vein thrombosis, and nonsignificant puncture site hematomas (19.5%). Long-term follow-up was conducted in 23 patients: 91% resumed regular menstrual cycles, 8.7% dysmenorrhea. New pregnancy occurred in 13% (two full-term pregnancies and one voluntary termination). Immediate efficacy, low morbidity and preservation of fertility make embolization the technique of choice for severe PPH.},

  doi          = {10.1007/S00270-003-2698-6},

  url          = {https://www.osti.gov/biblio/21088254},
  journal      = {Cardiovascular and Interventional Radiology},

  issn         = {0174-1551},

  number       = 4,

  volume       = 27,

  place        = {United States},

  year         = {Sun Aug 15 00:00:00 EDT 2004},

  month        = {Sun Aug 15 00:00:00 EDT 2004}

}

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