Effectiveness of embolization of the internal iliac or uterine arteries in the treatment of massive obstetrical and gynecological hemorrhages

摘要

OBJECTIVE: This study evaluated the effectiveness of embolization of internal iliac artery or uterine artery in the treatment of massive obstetrical and gynecological hemorrhages, including postpartum hemorrhages. PATIENTS AND METHODS: A total of 21 patients with massive obstetrical and/or gynecological hemorrhages underwent the modified Seldinger procedure. The catheter was inserted into the femoral artery on one side. Then, internal iliac artery angiography was performed to identify lesions in the areas supplied by internal iliac artery, and the bleeding site. Gelatin sponge particles were injected to embolize the bleeding artery. A second angiography was performed to determine whether embolization was successful. RESULTS: Clinical success was achieved in 20 patients after a single embolization procedure. Hysterectomy was performed in one woman with pernicious placenta previa due to persistent massive bleeding 24 hours after the removal of uterine packing. In the remaining 20 patients, the uterus was preserved. All 21 patients were cured and discharged. CONCLUSIONS: Embolization of internal iliac artery or uterine artery is an effective method to treat massive obstetrical and gynecological hemorrhages, including postpartum hemorrhages, and provides a new option to preserve the uterus.