Uterine Artery Embolization for Obstetric Hemorrhages

Abstract

This is a case report of a single woman who had uterine artery embolization to treat two episodes of obstetric hemorrhages, the first one occurring during the puerperium and the second one occurring after a medically assisted pregnancy termination (UAE). In this unusual case, the interventional radiological technique twice saved her life while she was pregnant.

A 29-year-old lady with a history of para 2 and living 2 (P2L2) appeared with a complaint of p/v spotting and a history of using tablets recently to end her pregnancy medically (MTP). She was treated conservatively after retained products of conception (RPOC) were ruled out radiologically. She then showed up with an abrupt uterine bleed, severe anaemia, and weakness. She was immediately brought up for bilateral UAE after the initial resuscitation and failure of conservative treatment. During her menstrual cycle five years earlier, she had also undergone UAE.

Introduction

An increasingly popular technique for hemostasis in obstetric hemorrhages that preserves fertility and menstruation is uterine artery embolization (UAE) . UAE is one of the interventions that has shown promising results in the management of acute obstetrical haemorrhage.

UAE provides as a minimally invasive option for controlling postpartum haemorrhage (PPH) that is resistant to medical intervention. The reliability and efficacy of UAE as a fertility-saving intervention for PPH have been demonstrated in numerous studies. However, complications after UAE, including as uterine infection and ovarian dysfunction, are believed to affect a woman’s future ability to conceive and her capacity to give birth to a child.

When there are huge fibroids and there are major risk concerns for surgery or when the patient wants to keep the uterus, AE is frequently prescribed. It is occasionally carried out to lessen the risk of significant haemorrhage brought on by retained foetal products prior to dilatation and curettage or hysteroscopic resection. In postpartum and postabortion situations, it also acts as a life-saving technique.

When compared to surgical treatments, UAE has proven to be a minimally invasive method with lower morbidity and quicker recovery. The only absolute contraindications to this technique, however, are suspected pregnancies, active or recent pelvic infection, and severe radiographic contrast allergy.