Pelvic arterial embolization for postpartum hemorrhage: long term results of a single center experience in 29,091 deliveries

Purpose of investigation: To evaluate the rate of all postpartum hemorrhages (PPHs) treated with uterine embolization in a third level delivery center. Materials and Methods: Since January 2008 to March 2014, 29,091 deliveries were registered in the present hospital in Bergamo, Italy. Among these deliveries, 2,002 cases (6.8%) of PPHs occurred. Seventy-three patients with severe obstetric hemorrhage underwent uterine artery embolization (UAE) (47 cases, 1.61/1,000 deliveries) or hysterectomy (26 cases, 0.89/1,000 deliveries). All identified cases were followed up by telephone on January 2015 in order to evaluate long term results. Results: Embolization was performed successfully in 45 patients (95.7%). Two women underwent total abdominal hysterectomy: one patient for uterine atony and one for adherent placenta. In the follow up all the women interviewed reported the return of their menstrual cycle and 95.2% of women reported regular cycles. Conclusions: Embolization showed a success rate of 95.7%. For this reason, in the authors’ opinion, it is the best choice as second line treatment of PPH, when patient is hemodynamically stable.