[Embolization as treatment for postpartum hemorrhage]

Area of Science:

• Obstetrics and Gynecology
• Interventional Radiology

Background:

• Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality worldwide.
• Conservative management for PPH, including curettage and hematoma evacuation, can be ineffective in severe cases.
• Hysterectomy is often considered a last resort for intractable PPH, particularly in young women desiring future fertility.

Observation:

• Two young women experienced severe postpartum bleeding, unresponsive to initial conservative treatments.
• Uterine artery embolization was performed as an alternative to hysterectomy.
• The cervicouterine branches of the uterine arteries were targeted for embolization.

Findings:

• Uterine artery embolization was technically successful in both cases.
• Embolization effectively controlled the postpartum hemorrhage, halting blood loss.
• Both patients experienced a successful outcome without requiring hysterectomy.

Implications:

• Uterine artery embolization is a viable, minimally invasive alternative to hysterectomy for managing refractory postpartum bleeding.
• This fertility-sparing approach preserves the uterus, offering hope for future pregnancies.
• Multidisciplinary collaboration between gynecologists and interventional radiologists is crucial for successful implementation.