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European Radiology

, Volume 19, Issue 9, pp 2197–2203 | Cite as

Severe primary postpartum hemorrhage due to genital tract laceration after operative vaginal delivery: successful treatment with transcatheter arterial embolization

  • Yann Fargeaudou
  • Philippe SoyerEmail author
  • Olivier Morel
  • Marc Sirol
  • Olivier le Dref
  • Mourad Boudiaf
  • Henri Dahan
  • Roland Rymer
Interventional

Abstract

The purpose of this study was to report our experience in the management of severe primary postpartum hemorrhage due to genital tract laceration following operative vaginal delivery with forceps using pelvic transcatheter arterial embolization (TAE). Ten women (mean age, 31.9 years) with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps were treated with TAE. TAE was indicated because of intractable bleeding that could not be controlled with uterotonic drugs, blood transfusion, attempted suturing and packing in all patients. Postdelivery perineal examination showed cervical or vaginal tears in all women and associated paravaginal hematoma in four. Angiography revealed extravasation of contrast material in six patients. TAE performed with gelatin sponge allowed to control the bleeding in all patients. Cervical and vaginal suturing was made possible and successfully achieved in the six women who had failed suturing attempts before TAE. Paravaginal hematoma was successfully evacuated in four patients in whom it was present after TAE. No complications related to TAE were noted. We conclude that in women with severe primary postpartum hemorrhage due to genital tract laceration after operative delivery with forceps, TAE is effective and safe for stopping the bleeding and helps genital tract suturing and evacuation of hematoma.

Keywords

Arterial embolization Arteries Postpartum hemorrhage Operative delivery Genital tract laceration Uterus Hemorrhage 

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Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Yann Fargeaudou
    • 1
  • Philippe Soyer
    • 1
    Email author
  • Olivier Morel
    • 2
  • Marc Sirol
    • 1
  • Olivier le Dref
    • 1
  • Mourad Boudiaf
    • 1
  • Henri Dahan
    • 1
  • Roland Rymer
    • 1
  1. 1.Department of Abdominal & Interventional ImagingHôpital Lariboisière-APHP-GHU Nord and Université Diderot-Paris 7Paris cedex 10France
  2. 2.Department of ObstetricsHôpital Lariboisière-APHP-GHU Nord and Université Diderot-Paris 7Paris cedex 10France

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