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European Radiology
Published in: European Radiology 2/2017

01-02-2017 | Vascular-Interventional

Short & long term adverse outcomes after arterial embolisation for the treatment of postpartum haemorrhage: a systematic review

Authors: Marie-Aimée Päivi Soro, Alban Denys, Maud de Rham, David Baud

Published in: European Radiology | Issue 2/2017

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Abstract

Objectives

Arterial embolisation (AE) plays a major role in current practice in the management of postpartum haemorrhage (PPH) that fails to respond to conservative treatment. While its benefit is well known, long-term outcomes of AE have been poorly investigated. The objective of this review is to assess its potential complications and long-term effects on the patients’ quality of life.

Methods

Using the terms “embolisation” and “postpartum haemorrhage”, we searched the Cochrane Central Register of Controlled Trials, Medline and PubMed for published studies. We limited the search to articles in English and French reporting “complications”, “fertility”, “menstruation” or “menstrual cycle” in humans. To ensure completeness, the references of extracted articles and review articles were also searched.

Results

The fertility rate in patients attempting another pregnancy reaches 70–80 %. Pregnancies following AE for PPH are not associated with a higher rate of intrauterine growth restriction. Pathological placentation (placenta accreta/increta/percreta) occurs more frequently after AE than in the general population. Psychological wellbeing, post-traumatic stress and sexual dysfunction after a life-threatening PPH requiring AE will require further investigation.

Conclusion

AE does not appear to adversely affect menstrual cycle, fertility and subsequent pregnancies, but may affect placentation. The experience of a life-threatening PPH, however, might prevent couples from pursuing another pregnancy.

Key Points

• Embolisation for PPH does not adversely affect menstrual cycle and fertility
• Experience of life-threatening PPH might prevent couples from pursuing another pregnancy
• Pathological placentation seems to occur more frequently after embolisation for PPH
Appendix
Available only for authorised users
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Metadata
Title
Short & long term adverse outcomes after arterial embolisation for the treatment of postpartum haemorrhage: a systematic review
Authors
Marie-Aimée Päivi Soro
Alban Denys
Maud de Rham
David Baud
Publication date
01-02-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4395-2

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