Uterine artery embolization (postpartum hemorrhage)

Background and indications

Postpartum hemorrhage is a potentially fatal obstetric emergency. Embolization is offered when medical treatments (uterotonics) and obstetric maneuvers (uterine revision, balloon) have failed to stop bleeding.

Benefits

Stops bleeding while preserving the uterus (and therefore fertility), unlike hemostatic hysterectomy which is the surgical alternative.

Procedure

In emergency, a catheter is introduced via the femoral artery and guided to the uterine arteries. Resorbable gelatin is injected into both uterine arteries to stop bleeding. The procedure lasts 30 minutes to 1 hour.

Risks

Uterine ischemia (rare), focal necrosis, post-embolization fever. Success rate is approximately 90%.

Recovery and follow-up

Monitoring in maternity or intensive care. Fertility return is normal after resorbable gelatin embolization.

Practical information

Local anesthesia. Outpatient procedure (return home the same day).