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The impact of uterine artery embolization to reduce postpartum hysterectomy

  • Original Article
  • Published:
Gynecological Surgery

Abstract

Uterine artery embolization (UAE) has been part of treatment options for postpartum hemorrhage (PPH) at Oslo University Hospital since 2007. We wanted to investigate if introduction of UAE influenced the incidence of postpartum hysterectomy and in addition to evaluate clinical success and fertility after UAE. This retrospective study includes patients treated for severe PPH undergoing UAE from 2007 to 2010 and patients undergoing hysterectomy in the period before (2003–2006) and after (2007–2010) the introduction of UAE. Hospital records were reviewed. Patients who were embolized were contacted with a questionnaire to evaluate fertility. We observed a decrease in the incidence of postpartum hysterectomy since introduction of UAE for PPH; however, the reduction was not significant (0.40/1000 versus 0.35/1000, p = 0.80). UAE resulted in clinical success in 28 patients (82 %). None were re-embolized. Twenty women were hysterectomized. Five of these patients had preceding embolization, four were hysterectomized due to re-bleeding, and one due to sepsis with suspected uterine necrosis. One patient had a uterine horn removed due to bleeding. Nine women became pregnant after UAE. There were 11 reported pregnancies and 8 live births. PPH re-occurred in 63 % of live births, with median bleeding volume of 700 ml (range 500–1600 ml). Introducing UAE decreased postpartum hysterectomy rate in our department, however not significant. Our success rate of UAE (82 %) is in line with previously published data. UAE may preserve fertility potential. High recurrence rate of PPH after previous UAE was observed.

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Acknowledgments

We would like to thank Unni Bergerud and her staff at the Department for Immunohematology and Professor Leiv Sandvik at the Department of Statistics at Oslo University Hospital for their contribution to this article

Authors’ contribution

MK Aas-Eng was responsible for the project development, data collection, data analysis, and manuscript writing. E Qvigstad, NE Kløw, and K Hald participated in the project development, data analysis, and manuscript writing.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Oslo University Hospital, Postboks 4950, Nydalen, 0424, Oslo, Norway

    Mee Kristine Aas-Eng, Erik Qvigstad & Kirsten Hald

  2. Faculty of Medicine, University of Oslo, Oslo, Norway

    Erik Qvigstad & Nils-Einar Kløw

  3. Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway

    Nils-Einar Kløw

Authors
  1. Mee Kristine Aas-Eng
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  2. Erik Qvigstad
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  3. Nils-Einar Kløw
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  4. Kirsten Hald
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Corresponding author

Correspondence to Mee Kristine Aas-Eng.

Ethics declarations

The study was approved by the Regional Committee for Medical and Health Research Ethics, South East Norway, and permission from OUH’s Advisory Committee on the Protection of Patient Records was granted for the study protocol.

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed written consent was obtained from patients who had been contacted with a questionnaire regarding fertility outcomes after embolization for postpartum hemorrhage.

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Aas-Eng, M.K., Qvigstad, E., Kløw, NE. et al. The impact of uterine artery embolization to reduce postpartum hysterectomy. Gynecol Surg 13, 153–158 (2016). https://doi.org/10.1007/s10397-016-0936-6

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  • DOI: https://doi.org/10.1007/s10397-016-0936-6

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