CardioVascular and Interventional Radiology

, Volume 39, Issue 8, pp 1159–1164 | Cite as

Endovascular Management of Intractable Postpartum Hemorrhage Caused by Vaginal Laceration

  • Masamichi KoganemaruEmail author
  • Masaaki Nonoshita
  • Ryoji Iwamoto
  • Asako Kuhara
  • Masakazu Nabeta
  • Masashi Kusumoto
  • Tomoko Kugiyama
  • Yutaka Kozuma
  • Shuji Nagata
  • Toshi Abe
Technical Note



We evaluated the management of transcatheter arterial embolization for postpartum hemorrhage caused by vaginal laceration.

Materials and Methods

We reviewed seven cases of patients (mean age 30.9 years; range 27–35) with intractable hemorrhages and pelvic hematomas caused by vaginal lacerations, who underwent superselective transcatheter arterial embolization from January 2008 to July 2014. Postpartum hemorrhage was evaluated by angiographic vascular mapping to determine the vaginal artery’s architecture, technical and clinical success rates, and complications.


The vaginal artery was confirmed as the source of bleeding in all cases. The artery was found to originate from the uterine artery in three cases, the uterine and obturator arteries in two, or the internal pudendal artery in two. After vaginal artery embolization, persistent contrast extravasation from the inferior mesenteric artery as an anastomotic branch was noted in one patient. Nontarget vessels (the inferior vesical artery and nonbleeding vaginal arterial branches) were embolized in one patient. Effective control of hemostasis and no post-procedural complications were confirmed for all cases.


Postpartum hemorrhages caused by vaginal lacerations involve the vaginal artery arising from the anterior trunk of the internal iliac artery with various branching patterns. Superselective vaginal artery embolization is clinically acceptable for the successful treatment of vaginal laceration hemorrhages, with no complications. After vaginal artery embolization, it is suggested to check for the presence of other possible bleeding vessels by pelvic aortography with a catheter tip at the L3 vertebral level, and to perform a follow-up assessment.


Postpartum hemorrhage Vaginal laceration Transcatheter embolization Vaginal artery 


Compliance with Ethical Standards

Conflict of Interest

All authors declare no conflict of interest associated with this manuscript.

Statement of Informed Consent

Written informed consent was obtained from all individual participants included in this study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.


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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2016

Authors and Affiliations

  • Masamichi Koganemaru
    • 1
    Email author
  • Masaaki Nonoshita
    • 1
  • Ryoji Iwamoto
    • 1
  • Asako Kuhara
    • 1
  • Masakazu Nabeta
    • 1
  • Masashi Kusumoto
    • 1
  • Tomoko Kugiyama
    • 1
  • Yutaka Kozuma
    • 2
  • Shuji Nagata
    • 1
  • Toshi Abe
    • 1
  1. 1.Department of RadiologyKurume University School of MedicineKurumeJapan
  2. 2.Department of Obstetrics and GynecologyKurume University School of MedicineKurumeJapan

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