Chapter 13d - Management of obstetric hemorrhage: radiological management

Summary

The main indications for embolization are in the emergency treatment of postpartum hemorrhage (PPH) and electively, in high risk cases. Embolization has also successfully been used to treat hemorrhage secondary to ectopic pregnancy, gestational trophoblastic disease, and acquired uterine arterio-venous malformations. This chapter describes the role of interventional radiology in the management of emergency PPH. It also describes the role of interventional radiology in the elective or prophylactic management of PPH. A prime advantage of embolization is that it avoids the need for hysterectomy. The techniques of selective arterial embolization to treat emergency obstetric hemorrhage, and balloon occlusion used electively in high risk patients are proven safe and effective methods of treatment for obstetric hemorrhage. They can reduce transfusion requirements, preserve fertility and thus have the potential to reduce maternal morbidity and mortality.