Eficacia y seguridad de la embolización de arterias uterinas en el manejo de la hemorragia posparto

Abstract

Objective

To demonstrate the safety and efficacy of endovascular treatment in postpartum hemorrhage.

Material and methods

We conducted a retrospective observational study with a sample from our Interventional Vascular Radiology unit, from 2004 to 2020. Patients who developed postpartum hemorrhage treated by arterial embolization were selected. Inclusion criteria were established to standardize the study group. Variables for the study of the efficacy and safety of the technique are defined.

Results

The final sample of the study was 56 patients. Technical success turned was 100%, while clinical success after endovascular treatment was 92.85%, with a hysterectomy rate due to failed arterial embolization of 7.14%, with uterine rupture observed in 3 cases as a cause of postpartum hemorrhage. No technique-related mortality was recorded. The rate of periprocedural complications was 3.56%, the same as that of late complications. No major or infectious complications were recorded. The pregnancy rate after embolization was 23.52%.

Conclusions

Selective arterial embolization of the uterine artery in postpartum hemorrhage is a safe and effective procedure, being a therapeutic alternative in the face of failure of pharmacological and obstetric management, with preservation of fertility.