Postpartum hemorrhage with pelvic arterial embolization, study of 33 cases

OBJECTIVE: To describe our cases of postpartum hemorrhage (PPH) with pelvic arterial embolization (PAE). MATERIAL AND METHODS: All patients with PPH who underwent PAE in our center in the interval 2011-1016 were retrospectively studied, evaluating the technical procedure, clinical results, and subsequent fertility. RESULTS: There were 33 cases of PPH with PAE. The majority occurred in primiparous women (N = 22, 66.6%) who delivered vaginally (N = 20, 61%). In addition, most PPH with PAE cases had an early onset (N = 26, 79%) and were caused by uterine atony (N = 14, 42.4%). Success of PAE occurred in 27 (81.8%) cases and a satisfactory clinical follow-up was the rule, with 21 (64%) women recovering their normal menstruation, and six (18.2%) becoming pregnant in the following years. CONCLUSIONS: PAE is a safe and efficacious technique with minor complications. Moreover, it allows conservation of the uterus with preservation of fertility.