Recurrence of post‐partum hemorrhage in women with a history of uterine artery embolization

Imafuku, Hitomi; Yamada, Hideto; Morizane, Mayumi; Tanimura, Kenji

doi:10.1111/jog.14129

Cited by 10 publications

(4 citation statements)

References 21 publications

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“…Prior UAE is associated with an increased rate of placenta accreta spectrum and PPH during subsequent pregnancies (14–16). In our study, one patient presented with placenta accreta that led to PPH.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have evaluated the effect of UAE on future fertility and demonstrated sufficient pregnancy outcomes (9)(10)(11)(12)(13). However, a few studies focused on an enhanced risk for placental disorders and PPH recurrence in subsequent pregnancies (14)(15)(16). As the rate of UAE has increased for PPH (17), detailed information on pregnancy outcomes, including complications, should be revealed.…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes and future fertility after uterine artery embolization for postpartum and post-abortion hemorrhage

Chatani,

Inoue,

Lee

et al. 2024

Acta Radiol

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Background Postpartum hemorrhage (PPH) and post-abortion hemorrhage (PAH) are life-threatening conditions. Purpose To evaluate the efficacy and safety of uterine arterial embolization (UAE) for PPH and PAH and to investigate future fertility after UAE. Material and Methods This study included 57 consecutive patients (mean age = 34 years) who underwent UAE for PPH (n = 46) and PAH (n = 11) at our institution between January 2011 and December 2022. Technical success, non-visualization of the peripheral portion of bilateral uterine arteries on angiography, and clinical success, complete hemostasis after UAE, were assessed. UAE-associated complications and factors related to clinical success were analyzed. Pregnancy outcomes after UAE and complications during subsequent pregnancy were investigated in 16 patients who desired fertility and were followed up for >1 year. Results The technical and clinical success rates were 100% and 84.2%, respectively. Sepsis (n = 1) and uterine empyema (n = 1) were observed as severe complications. Placental disorder, bleeding within 24 h after delivery or abortion, ≥1.5 shock index, ≥6 units of transfusion erythrocytes, and ≥8 obstetrical disseminated intravascular coagulation score were significantly associated with unfavorable clinical outcomes. In total, 16 pregnancies were observed in 12 patients after UAE, three of which were miscarriages and 13 were successful live births. During pregnancy, uterine rupture (n = 1) and accreta (n = 1) were observed. Conclusion UAE is an effective treatment for PPH and PAH. Although UAE could preserve future fertility, careful attention should be paid to perinatal management for unusual complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical outcomes and future fertility after uterine artery embolization for postpartum and post-abortion hemorrhage

Chatani,

Inoue,

Lee

et al. 2024

Acta Radiol

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“…Оценке течения и исходов последующих после ЭМА беременностей и родов у пациенток с гипотоническим ПРК посвящены исследования ряда зарубежных авторов и описаны следующие осложнения: рецидив гипотонического ПРК -у 31,6%, врастание плацентыу 17,7-50% [25,[28][29][30]…”

Section: Discussionunclassified

Long-term outcomes of uterine artery embolization in patients with early hypotonic postpartum hemorrhage

Konoplev,

Breslav,

Kurtser

et al. 2024

Medicinskij sovet

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Introduction. Obstetric haemorrhage remains the number one cause of maternal death globally. Today, the frequency of hypotonic postpartum hemorrhage (PPH) reaches 80% in the obstetric hemorrhage profile.Objective. To evaluate the long-term outcomes of uterine artery embolization (UAE) for the treatment of early hypotonic postpartum hemorrhage (PPH).Material and methods. 136 patients were examined 2–8 years after UAE performed for early hypotonic postpartum hemorrhage. A survey was conducted for everyone. Ultrasound of the pelvic organs on the 5th–7th day of the menstrual cycle with an assessment of endometrial thickness, ovarian volume, number of antral follicles, and also Dopplerography were performed in 34 patients. Hormonal status was studied in 34 patients, that were examined in the first phase of the menstrual cycle, with an assessment of serum levels of anti-Mullerian hormone (AMH), follicle-stimulating (FSH) and luteinizing (LH) hormones.Results. 19.1% (26/136) of patients planned pregnancy. Pregnancy occurred in 61.5% (16/26). Term delivery occurred in 38.5% (10/26), PPH recurrence occurred in 30% (3/10), placenta accretion was not detected. 23.1% (6/26) patients were pregnant at the time of the survey. Neither morphological nor functional changes of the ovaries were detected in patients 2–8 years after UAE.Conclusions. Uterine artery embolization is a safe method of therapy of early hypotonic postpartum hemorrhage.

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“…UAE provides as a minimally invasive option for controlling postpartum hemorrhage (PPH) that is resistant to medical intervention [ 3 ]. Numerous studies have shown the reliability and effectiveness of UAE as a fertility-saving intervention for PPH [ 4 ]. However, problems following UAE, like uterine infection and ovarian malfunction, are thought to impact a woman's ability to conceive in the future and her ability to bear a child [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Repeat Uterine Artery Embolization for Obstetric Hemorrhages: A Rare Event in a Single Patient

Sinha¹,

Acharya²,

Banode³

2022

Cureus

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This is a case report of a single patient who had two episodes of obstetric hemorrhages, first in the puerperium and second one post medical termination of pregnancy for which the patient had to be managed by uterine artery embolization (UAE). This is a rare case in which this interventional radiological procedure proved life-saving twice in her obstetric history.A 29-year-old woman with an obstetric history of para two and living two (P2L2), presented with a complaint of per-vaginum (p/v) spotting with a history of recent intake of pills for medical termination of pregnancy (MTP). Retained products of conception (RPOC) were ruled out radiologically and she was managed conservatively. She subsequently presented with acute uterine bleed with severe anemia and lethargy. After initial resuscitation and failing of conservative therapy, she was promptly taken up for bilateral UAE. She had also undergone UAE 5 years ago during her puerperal period.Uterine artery embolization is a safe and effective life-saving procedure to control torrential uterine bleed and should be considered when the conservative approach has failed.

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Recurrence of post‐partum hemorrhage in women with a history of uterine artery embolization

Cited by 10 publications

References 21 publications

Clinical outcomes and future fertility after uterine artery embolization for postpartum and post-abortion hemorrhage

Clinical outcomes and future fertility after uterine artery embolization for postpartum and post-abortion hemorrhage

Long-term outcomes of uterine artery embolization in patients with early hypotonic postpartum hemorrhage

Repeat Uterine Artery Embolization for Obstetric Hemorrhages: A Rare Event in a Single Patient

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