Serious primary post-partum hemorrhage, arterial embolization and future fertility: a retrospective study of 46 cases.

Abstract : BACKGROUND: The guidelines advise arterial embolization in case of post-partum hemorrhage. We evaluated its feasibility and the subsequent fertility. METHODS: A retrospective study has been conducted in our center for the past 10 years (1996-2005). Fifty-two patients experiencing a primary post-partum hemorrhage who were resistant to medical treatment underwent uterine artery embolization and/or hysterectomy. In case of arterial embolization, a follow-up of all the patients was realized, focusing on the preservation of fertility. RESULTS: Six (11.5%) patients underwent hysterectomy straightaway and 46 (88.5%) arterial embolization in the first instance including 35 arterial embolizations after Cesarean section. Embolization was successful among 41 patients (89.1%) and hysterectomy was performed on the 5 (10.9%) others. Overall, 11/24 398 women suffered from a definitive loss of fertility after post-partum hemorrhage. Fertility was studied at least 1 year after the delivery. All patients had a return of normal menses. Sixteen of 41 women (39%) wanted another child and 100% succeeded. Nineteen pregnancies, including two twin pregnancy and one early spontaneous abortion were observed. CONCLUSIONS: Embolization is a safe and effective non-surgical method to resolve post-partum hemorrhage and should be regarded as gold standard in a hemodynamically stable patient. Furthermore, subsequent fertility is not impaired by the procedure.
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Human Reproduction, Oxford University Press (OUP), 2008, 23 (7), pp.1553-9. 〈10.1093/humrep/den122〉
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Soumis le : jeudi 10 décembre 2009 - 14:29:16
Dernière modification le : mercredi 14 mars 2018 - 16:44:10

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C. Chauleur, C. Fanget, G. Tourne, R. Levy, C. Larchez, et al.. Serious primary post-partum hemorrhage, arterial embolization and future fertility: a retrospective study of 46 cases.. Human Reproduction, Oxford University Press (OUP), 2008, 23 (7), pp.1553-9. 〈10.1093/humrep/den122〉. 〈ujm-00440351〉

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