Early Intervention With UAE Studied to Treat Postpartum Hemorrhage

March 20, 2024—Early intervention with uterine artery embolization (UAE) can help women avoid hysterectomy due to severe bleeding after childbirth, according to a new study by Younes Jahangiri, MD, et al.

The study was a retrospective review of 66 patients (median age, 31 years) who underwent UAE for uncontrolled postpartum hemorrhage (PPH) at a single, high-volume medical center between 2014 and 2022.

The Society of Interventional Radiology (SIR) announced that the findings will be presented as Abstract #189 at SIR 2024, the society’s annual scientific meeting held March 23-28 in Salt Lake City, Utah.

According to the press release from SIR, the investigators found that UAE successfully controlled PPH in 62 of the 66 patients (94%). Four patients required hysterectomies to stop the bleeding, all of whom lost at least 2,400 mL of blood prior to presentation for UAE and symptoms of diffuse intravascular coagulopathy, which can happen after large-volume hemorrhage caused by rapid consumption of clotting factors.

The SIR press release further reported that the study investigators found a 36% incidence of postembolization syndrome, which presents with abdominal pain and flu-like symptoms. This was more likely to occur in patients who experienced greater blood loss before embolization.

“These findings are important and may help more women avoid hysterectomy and other very serious complications of uncontrolled hemorrhage,” commented Dr. Jahangiri in the SIR press release.

Dr. Jahangiri, a resident in the interventional and diagnostic radiology program at Michigan State University/Corewell Health in Grand Rapids, Michigan, added. “As the medical community looks for ways to provide better care for women to address maternal health and peripartum care, this is one more option on the table that could help many women.”

James Morrison, MD, is senior investigator of the study and Assistant Professor of Interventional Radiology at Michigan State University’s College of Human Medicine.

Dr. Morrison stated in the SIR press release, “Based on these findings, we would encourage obstetricians to involve interventional radiologists early to be ready to perform UAE if more conservative approaches are not managing PPH.”

The investigators plan to expand their research to include multiple institutions and ultimately to conduct a prospective study that examines longer-term outcomes of UAE, advised the SIR press release.