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Obstetrics & Gynecology 2008;111:881-889
© 2008 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Uterine Artery Embolization in Postabortion Hemorrhage

Jody E. Steinauer, MD, MAS1, Justin T. Diedrich, MD1, Mark W. Wilson, MD2, Philip D. Darney, MD, MSc1, Juan E. Vargas, MD1 and Eleanor A. Drey, MD, EdM1

From the 1Bixby Center for Reproductive Health Research and Policy; and San Francisco General Hospital, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California; and 2Department of Radiology, University of California, San Francisco, California.

OBJECTIVE: To summarize the efficacy of postabortion uterine artery embolization in cases of refractory hemorrhage.

METHODS: Forty-two women were identified who had postabortion uterine artery embolization at San Francisco General Hospital between January 2000 and August 2007. Seven underwent embolization for hemorrhage caused by abnormal placentation.

RESULTS: Embolization was successful in 90% (38 of 42) of cases. All failures (n=4) were in patients who had confirmed abnormal placentation. However, three of seven women (43%) with probable accreta diagnosed by ultrasonography were treated successfully with uterine artery embolization. Two patients experienced complications of uterine artery embolization. These complications—one contrast reaction and one femoral artery embolus—were treated without further sequelae.

CONCLUSION: Uterine artery embolization is an alternative to hysterectomy in patients with postabortion hemorrhage refractory to conservative measures, especially when hemorrhage is caused by uterine atony or cervical laceration.

LEVEL OF EVIDENCE: III






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