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Uterine Artery Embolization: A Case Report on Primary Postpartum Hemorrhage Management
Shruti H Mandviya1, Snehlata Hingway2, Vishal Ghule3
1Pathology and Laboratory Medicine, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus
|August 6, 2024
Summary
Uterine artery embolization (UAE) effectively controlled postpartum hemorrhage (PPH) when other treatments failed. This minimally invasive procedure rapidly stopped bleeding, stabilizing the patient and preserving fertility.
Area of Science:
- Obstetrics and Gynecology
- Interventional Radiology
- Vascular Surgery
Background:
- Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality globally.
- Traditional management of refractory PPH includes uterotonics and surgical interventions, which may not always be successful.
- Uterine artery embolization (UAE) is an established endovascular technique for managing gynecological bleeding.
Observation:
- A 32-year-old patient undergoing elective cesarean section developed refractory PPH despite medical and surgical management.
- The patient required packed red blood cell transfusion due to persistent, life-threatening hemorrhage.
- A multidisciplinary team decided to proceed with UAE due to the patient's critical condition.
Findings:
- UAE was performed using gelatin sponge particles as embolic agents.
- The procedure resulted in immediate cessation of uterine blood flow.
- The patient's condition rapidly stabilized following the embolization.
Implications:
- This case highlights UAE as a crucial, effective intervention for severe PPH unresponsive to conventional therapies.
- Early consideration of UAE in refractory PPH can prevent further complications and improve maternal outcomes.
- UAE offers advantages such as targeted treatment, rapid hemostasis, and potential fertility preservation, warranting further research and optimization.
