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Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications

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Abstract

Postpartum hemorrhage (PPH) is a potentially life-threatening condition, which needs multidisciplinary management. Uterine atony represents up to 80 % of all causes of PPH. Transcatheter arterial embolization (TAE) has now a well-established role in the management of severe PPH. TAE allows stopping the bleeding in 90 % of women with severe PHH, obviating surgery. Pledgets of gelatin sponge as torpedoes are commonly used for safe TAE, and coils, glue, and microspheres have been primarily used in specific situations such as arterial rupture, pseudoaneurysm, and arteriovenous fistula. TAE is a minimally invasive procedure with a low rate of complications, which preserves future fertility. Knowledge of causes of PPH, potential risks, and limitations of TAE is essential for a timely decision, optimizing TAE, preventing irreversible complications, avoiding hysterectomy, and ultimately preserving fertility.

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Conflict of interest

Philippe Soyer, MD, PhD, Anthony Dohan, MD, BSc, Raphael Dautr MD, Youcef Guerrache, MD, Aude Ricbourg, MD, Etienne Gayat, MD, PhD, Mourad Boudiaf, MD, Marc Sirol, MD, PhD, and Olivier Ledref, MD have no conflicts of interest.

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  1. Department of Abdominal and Interventional Imaging, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France

    Philippe Soyer, Anthony Dohan, Raphael Dautry, Youcef Guerrache, Mourad Boudiaf, Marc Sirol & Olivier Ledref

  2. Diderot-Paris 7, Université-Sorbonne Paris-Cité, 10 Avenue de Verdun, 75010, Paris, France

    Philippe Soyer, Anthony Dohan, Raphael Dautry & Etienne Gayat

  3. Department of Obstetrics and Gynecology, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France

    Aude Ricbourg

  4. Department of Anesthesiology, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France

    Etienne Gayat

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  1. Philippe Soyer
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  2. Anthony Dohan
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  3. Raphael Dautry
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  4. Youcef Guerrache
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  5. Aude Ricbourg
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  6. Etienne Gayat
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  7. Mourad Boudiaf
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  8. Marc Sirol
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  9. Olivier Ledref
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Correspondence to Philippe Soyer.

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Soyer, P., Dohan, A., Dautry, R. et al. Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications. Cardiovasc Intervent Radiol 38, 1068–1081 (2015). https://doi.org/10.1007/s00270-015-1054-y

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  • DOI: https://doi.org/10.1007/s00270-015-1054-y

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