Pelvic arterial embolization offers alternative to hysterectomy for treatment of postpartum bleeding

May 05, 2003

Results of a recent study show that pelvic arterial embolization can be used safely and effectively to treat uncontrollable postpartum bleeding with little or no long-term side effects, says Michael Tal, MD, assistant professor and director of research in the section of interventional radiology at Yale University School of Medicine and an author of the study.

Women who have uncontrolled bleeding after giving birth are usually treated with medication, or in more extreme cases must undergo a hysterectomy, which leaves the patient infertile. Pelvic arterial embolization is a minimally invasive procedure, which is performed by an interventional radiologist. The radiologist inserts a small catheter into the arteries supplying the uterus and injects small particles that block the blood flow to the uterus and stops the bleeding.

In an effort to examine the long-term effects of embolization on fertility, Dr. Tal and his colleagues studied 28 patients who underwent pelvic arterial embolization for postpartum hemorrhage between the years 1977 and 2002. All of the patients, who wanted to get pregnant again after the embolization procedure, were able to do so; all pregnancies and deliveries were normal, says Dr. Tal.

Aside from preserving fertility, Dr. Tal says the women in his study who underwent pelvic arterial embolization did not experience any significant long-term side effects such as sexual dysfunction, bladder dysfunction, or psychological effects, which are commonly associated with hysterectomy. Furthermore, Dr. Tal says, "the recuperation period is much shorter and the women are discharged from the hospital much sooner than with hysterectomy." However, he says the length of the hospital stay depends on other factors including the amount of blood lost during postpartum hemorrhage.

Dr. Tal recommends using pelvic arterial embolization instead of hysterectomy and says the only time pelvic arterial embolization should not be used is "if the patient has already lost too much blood and is not stable enough to undergo the embolization procedure."

Stressing the importance of educating women and gynecologists, Dr. Tal says, "every woman who goes into a hospital for child birth should find out if the hospital has an interventional radiologist with the ability to perform pelvic arterial embolization. If she ends up having uncontrolled postpartum bleeding, and arterial embolization is not available, the patient might lose her uterus or her life. God forbid they will have complications, but women should know just in case things go wrong."

While other researchers have studied the procedure in the past, Dr. Tal says this study is the first to specifically examine the long-term effects associated with pelvic arterial embolization.
The study will be presented May 5, during the American Roentgen Ray Society Annual Meeting in San Diego.

Additional Contact Information:
Danica Laub (703) 858-4332
Keri Sperry (703) 858-4306
Press Room (619) 525-6536 (May 5-8)

Dr. Michael Tal (203) 785-7026

American College of Radiology

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