Arterial embolisation in intractable primary post-partum haemorrhage: case series

ML Tsang, WC Wong,KY Kun,CM Tai, TK Ng,KY Lau, TP Wong
Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong

OBJECTIVE. To evaluate the efficacy and safety of arterial embolisation in the management of intractable primary post-partum haemorrhage.

DESIGN. Retrospective case series.

SETTING. Regional hospital, Hong Kong.

PATIENTS. Nine patients aged 28 to 39 years who were treated for severe primary post-partum haemorrhage between October 2000 and January 2003.

INTERVENTION. Emergency transcatheter arterial embolisation.

MAIN OUTCOME MEASURES. Clinical outcome and complications.

RESULTS. All nine arterial embolisations successfully arrested the haemorrhage. The main cause of primary post-partum haemorrhage was uterine atony. No serious complication arose, although one patient experienced slight numbness of the right leg. Normal menstruation resumed in all patients, except for the one who had had a hysterectomy as initial treatment. One patient became pregnant 1 year after embolisation. Patients were followed up for 10 months.

CONCLUSION. In our experience, arterial embolisation is safe and efficacious, and is the treatment of choice for patients with intractable primary post-partum haemorrhage.

Hong Kong Med J 2004;10:301-6

Key words: Embolization; Gelatin sponge, absorbable; Postpartum hemorrhage