The efficacy and complications of uterine artery embolization in patients with late postpartum hemorrhage (Quasi-experimental study)

Abstract

Introduction: One of the most common causes of maternal death worldwide is postpartum hemorrhage (PPH). So far, no study has been performed in Iran to compare the effects of polyvinyl alcohol and foam gel embolizers on menstrual pattern after uterine artery embolization. Therefore, this study was performed with aim to evaluate the efficacy and complications of uterine artery embolization (UAE) in patients with late PPH. Methods: This quasi-experimental study was performed on 70 patients with late postpartum hemorrhage referred to the Isfahan Educational and Medical Centers, Al-Zahra and Khorshid hospitals in 2019-2020. In this study, 30 patients with foam gel embolizer and 40 patients with polyvinyl alcohol embolizer underwent uterine artery embolization. Patients were followed for 6 months; menstrual pattern and complications of UAE were compared in the two groups. Data were analyzed by SPSS statistical software (version 22) and Independent t-test, Chi-square and Fisher's exact test. P<0.05 was considered statistically significant. Results: In this study, the clinical success rate was 91.4% and the technical success rate was 100%. The pattern of normal menstruation in the two groups after first three months was 61.7% and after the second three months was 91.4%. There was no significant difference between the two groups after six months of follow-up (p =0.18). The overall complication rate was 13.3%, of which 10.8% was post-embolization syndrome and 2.5% was local ischemia of the external genitalia. Conclusion: UAE is an effective and safe method for treatment of women with late PPH.

Keywords

• gelfoam
• polyvinyl alcohol
• postpartum hemorrhage (pph)
• uterine artery embolization (uae)