Postpartum hemorrhage (PPH) is reported in about 5% of deliveries. Its First-line treatment involves pharmacological measures, intrauterine tamponade, uterine artery ligation, and uterine compression sutures. Uterine artery embolization (UAE) is however performed in women with treatment-refractory severe PPH. If these procedures fail to achieve homeostasis, then a hysterectomy is performed.
UAE is a reasonable alternative to hysterectomy for managing severe PPH as it is an effective and minimally invasive procedure with feasible side effects and a uniform success rate of >90% for attaining hemostasis.
A recent study inspects the obstetric complications during subsequent pregnancies after UAE for PPH by investigating the relationship between prior UAE and obstetric complications through a meta-analysis.
This study specifies the effect of prior UAE for PPH on the rate of placenta accreta spectrum (PAS), PPH, placenta previa, hysterectomy, fetal growth restriction (FGR), and preterm birth (PTB). It includes 23 retrospective studies with 483 pregnancies with prior UAE and 320,703 pregnancies without prior UAE.
The observations from the study are as follows-
This study highlights prior UAE for PPH as a significant risk factor for PAS and PPH during subsequent pregnancies. Thus, during delivery, clinicians should be more cautious about PAS and PPH in women with a history of prior UAE.
The limited sample size warrants further investigations to confirm the results of this study.
Source: Sci Rep. 2021 Aug 19;11(1):16914. doi: 10.1038/s41598-021-96273-z. PMID: 34413380; PMCID: PMC8377070.