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Updated: May 20, 2026

Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri

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Published on: September 12, 2025

[Selective embolization to treat obstetric hemorrhage].

M D Ferrer Puchol¹, C Lanciego², E Esteban¹

¹Servicio de Radiología, Hospital de la Ribera, Alzira, Valencia, España.

|July 6, 2012

Summary

Selective intra-arterial embolization effectively treats obstetric hemorrhage with a high success rate. This procedure demonstrates good clinical outcomes and preserves post-treatment fertility in women.

Keywords:

Angiography Arteriografía Complicaciones del trabajo del parto Embolización arterial uterina Fertilidad Fertility Hemorragia posparto Obstetric labor complications Postpartum hemorrhage Uterine artery embolization

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Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri

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Published on: December 22, 2023

Area of Science:

Interventional Radiology
Obstetrics & Gynecology
Vascular Surgery

Background:

Obstetric hemorrhage remains a leading cause of maternal morbidity and mortality worldwide.
Selective intra-arterial embolization is an established treatment option for severe postpartum hemorrhage unresponsive to conservative management.

Purpose of the Study:

To detail cases requiring selective intra-arterial embolization for obstetric hemorrhage.
To evaluate the various embolization techniques employed.
To assess clinical outcomes and subsequent fertility.

Main Methods:

A retrospective study of 27 women with obstetric hemorrhage undergoing selective intra-arterial embolization.
Catheterization of uterine arteries (bilateral in 24, unilateral in 2 for pseudoaneurysm).
Embolization materials included Spongostan (17/27), particles (9/27), and coils (1/27).

Main Results:

Hemorrhage was primarily primary (25/27) or secondary (2/27), linked to vaginal delivery (20), C-sections (5), abortion (1), and ectopic pregnancy (1).
Initial technical success was 100%, with a 92.6% clinical success rate (25/27 patients).
Follow-up (1-7 years) showed normal menstruation in 23 patients and 7 full-term pregnancies in 6 patients.

Conclusions:

Intra-arterial embolization is a safe and effective treatment for obstetric hemorrhage.
The procedure is associated with minimal complications.
Fertility is preserved following embolization, allowing for future pregnancies.