Recurrent Bleeding Within 24 Hours After Uterine Artery Embolization for Severe Postpartum Hemorrhage: Are There Predictive Factors? View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-06

AUTHORS

Sébastien Bros, Pascal Chabrot, Adrian Kastler, Lemlih Ouchchane, Lucie Cassagnes, Denis Gallot, Louis Boyer

ABSTRACT

PURPOSE: To retrospectively identify predictive factors of recurrent bleeding within 24 h after uterine artery embolization (UAE) for postpartum hemorrhage (PPH). MATERIALS AND METHODS: A total of 194 patients underwent UAE for PPH between August 1999 and April 2009 at our institution. Twelve patients experienced recurrent bleeding within the next 24 h; a second attempt at UAE was thus necessary, which was successful in 10 cases. In two cases, hemostatic hysterectomy was performed. Epidemiological, gynecological-obstetrical, anatomic, and biological data were analyzed. RESULTS: Complete data were available for 148 of the 194 (76%) included patients. Sixty-four (43%) were primiparous, 18 (12.2%) had a placenta accreta, 21 (14%) had a coagulopathy, and 28 (18.9%) had an anatomic variant of the uterine arterial vasculature. Mean age and pregnancy term were similar in both recurring and nonrecurrent bleeding groups. After multivariate analysis, three criteria emerged as risk factors of recurrent bleeding: primiparity (10 patients, 83%; odds ratio [OR]=18.84; P=0.014), coagulation disorders (6 patients, 50%; OR=12.08; P=0.006), and anatomic variant of the uterine arterial vasculature (28 patients; OR=9.83; P=0.003). CONCLUSION: Search for uterine collaterals must be performed before UAE for PPH. Primiparity and coagulation disorders increase the risk of recurrent bleeding after UAE for PPH. More... »

PAGES

508-514

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00270-011-0181-3

DOI

http://dx.doi.org/10.1007/s00270-011-0181-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1039159838

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/21614439


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