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Short & long term adverse outcomes after arterial embolisation for the treatment of postpartum haemorrhage: a systematic review.
- Source :
-
European radiology [Eur Radiol] 2017 Feb; Vol. 27 (2), pp. 749-762. Date of Electronic Publication: 2016 May 26. - Publication Year :
- 2017
-
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.<br />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.<br />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.<br />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.<br />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.
- Subjects :
- Endometritis etiology
Female
Humans
Necrosis epidemiology
Necrosis etiology
Postoperative Complications etiology
Pregnancy
Quality of Life
Uterine Diseases etiology
Vascular System Injuries etiology
Embolization, Therapeutic adverse effects
Endometritis epidemiology
Placenta Accreta epidemiology
Postoperative Complications epidemiology
Postpartum Hemorrhage therapy
Uterine Diseases epidemiology
Uterus pathology
Vascular System Injuries epidemiology
Venous Thrombosis epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1432-1084
- Volume :
- 27
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- European radiology
- Publication Type :
- Academic Journal
- Accession number :
- 27229338
- Full Text :
- https://doi.org/10.1007/s00330-016-4395-2