The efficacy of pelvic arterial embolisation for the treatment in massive vaginal haemorrhage in obstetric and gynaecological emergencies: a single-centre experience.

This study aimed to identify the role, efficacy and safety of pelvic arterial embolisation (PAE) in the management of massive vaginal haemorrhage occurring in 25 patients with obstetric and gynaecological emergencies where bleeding could not be controlled by conservative treatment methods. Nine of the cases had disseminated intravascular coagulation (DIC) and eight were haemodynamically unstable. PAE was successful in 23 of 25 patients without any major complication. Vascular blush was the most common (100%) angiographic finding. Active extravasation was observed in 9 of 25 of the cases. Permanent embolic agents including polyvinyl alcohol (PVA) particles or N-butyl-2-cyanoacrylate (NBCA) were used in all cases. Technical success in patients with disseminated intravascular coagulation (DIC), and in patients who were haemodynamically unstable were 9 of 11 and 6 of 8 cases, respectively. PAE was successful in all seven patients who had hysterectomy before PAE. PAE is a safe and effective alternative to surgical hysterectomy in obstetric and gynaecological emergencies when conservative management failed to control haemorrhage. It is an effective treatment option in cases of coagulation impairment and when bleeding cannot be controlled despite hysterectomy. Impact statement What is already known on this subject: Postpartum haemorrhage (PPH) is one of the most common causes of maternal morbidity and mortality worldwide. Most patients with PPH are treated conservatively but where t...
Source: Journal of Obstetrics and Gynaecology - Category: OBGYN Tags: J Obstet Gynaecol Source Type: research