Serious primary post-partum hemorrhage, arterial embolization and future fertility: a retrospective study of 46 cases

Abstract

Embolization is a safe and effective non-surgical method to resolve post-partum hemorrhage and should be regarded as gold standard in a hemodynamically stable patient. Furthermore, subsequent fertility is not impaired by the procedure.

Fertility and pregnancy following pelvic arterial embolisation for postpartum haemorrhage

“…Our study, which reports the largest number of pregnancies (n = 26) and full-term pregnancies (n = 19), confirms the results reported previously in the literature. [11][12][13][14][15][16][17][18][19][20][21][22][23][24] Contrary to our study, the majority of these case series, which have been published previously, did not use a systematic approach to follow-up and telephone contact with participants in an attempt to address subsequent fertility and obstetric outcome. Therefore, they did not 100 women eligible for inclusion in the study* 15 women encountered exclusion criteria peripartum hysterectomy (n = 9) performed before embolization (n = 2) after embolization (n = 7) embolization of vaginal arteries alone (n = 6) assess accurately the fertility outcome as they did not take into consideration the evaluation of desire and attempts to conceive.…”

“…8 Primary long-term studies suggest that uterine-sparing surgical procedures do not appear to impair subsequent fertility and pregnancy outcomes. [7][8][9][10] Previous studies of women undergoing embolisation have suggested that it does not impair subsequent fertility, [11][12][13][14][15][16][17][18][19][20][21][22][23][24] but the cohort, methodology and follow-up rate of these small case series are limited. 25 Moreover, in the majority of case series, no information is available regarding women with presumed preserved fertility and desire for pregnancy who do not become pregnant.…”

Interventional radiology for critical hemorrhage in obstetrics: Japanese Society of Interventional Radiology (JSIR) procedural guidelines

“…The reported clinical success rates of TAE for PPH range from 71.5 to 100 % [5,15]. Seven papers described failed TAE followed by hysterectomy [3,17]. The failure rate for TAE ranges from 4 to 12 %.…”

“…Uterine necrosis, vaginal fistula, Asherman syndrome. d. Death [15,17]. Four fatal cases have been reported.…”

“…The menstrual cycle resumes in 91-100 % of patients who have undergone emergency TAE [1,11,15,17,20,[35][36][37][38][39]. Pregnancy can be expected in 69-100 % (average, 79 %) of women who desire future pregnancy [35].…”