Recurrence of post-partum hemorrhage in women with a history of uterine artery embolization

J Obstet Gynaecol Res. 2020 Jan;46(1):119-123. doi: 10.1111/jog.14129. Epub 2019 Oct 13.

Abstract

Aim: To evaluate pregnancy outcome and complications in subsequent pregnancies after severe post-partum hemorrhage (PPH) between women with and without a history of uterine artery embolization (UAE).

Methods: Women who had a history of severe PPH, and delivered newborns at ≥22 gestational weeks in subsequent pregnancies were enrolled. Severe PPH was defined as blood loss volume of more than 2000 mL.

Results: The blood loss volume (median 1581 mL) in women with UAE (n = 14) was significantly more than that in women without UAE (median 1021 mL, n = 32, P < 0.01), and the recurrence rate of severe PPH in women with UAE (n = 5, 35.7%) was significantly higher than that in women without UAE (n = 3, 9.4%, P < 0.05). There were no significant differences in frequencies of premature delivery, hypertensive disorders of pregnancy, fetal growth restriction, or placenta previa/low lying placenta. Of 14 women with UAE, 7 (50.0%) had abnormally invasive placenta, whereas of 32 women without UAE, none had abnormally invasive placenta.

Conclusion: Subsequent pregnancies after UAE for severe PPH had high risks for recurrence of severe PPH.

Keywords: abnormally invasive placenta; placenta accrete; placenta increta; post-partum hemorrhage; uterine artery embolization.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Birth Intervals
  • Female
  • Humans
  • Infant, Newborn
  • Parity
  • Postpartum Hemorrhage / epidemiology
  • Postpartum Hemorrhage / etiology*
  • Pregnancy
  • Pregnancy Outcome
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Uterine Artery Embolization / adverse effects*