Endovascular management of postpartum hemorrhage of placental origin

AimTo evaluate the potential role, efficacy, and complications of endovascular management of postpartum hemorrhage induced by variable placental abnormalities.Materials and methodsTen patients with placental abnormalities underwent pelvic arterial embolization in Assiut University Hospital, because of postpartum hemorrhage. Placental abnormalities were; retained placenta (n = 4), placenta accrete vera (n = 1), placenta increta (n = 2), placenta percreta (n = 1), and choriocarcinoma (n = 2). Only three patients were embolized on emergency bases, while the other 7 patients were scheduled for embolization.ResultsThe mean hemoglobin level before embolization was 6 g/dL (range: 4.5–8 g/dL). Severe coagulation disorders were present in one patient. Postembolization pelvic angiogram showed total devascularization of the pathological arteries in 7(70%) patients, and subtotal devascularization in 3(30%) patients. The clinical success is 100%.ConclusionWhatever the placental disease, pelvic embolization with long-lasting embolizing agents is very effective and safe treatment of associated postpartum hemorrhage.