Postpartum hemorrhage in coagulopathic patients: preliminary experience with uterine arterial embolization with N-butyl cyanoacrylate.

The present report describes uterine artery embolization (UAE) with N-butyl cyanoacrylate (NBCA) in four patients with postpartum hemorrhage (PPH) in a coagulopathic condition. Initial UAE with gelatin sponge particles and/or fibered platinum microcoils had failed in these patients. Subsequently, a mixture of NBCA and iodinated poppy seed oil (Lipiodol) was used as embolic material, and hemostasis was achieved immediately in all patients. No vaginal bleeding recurred thereafter, and all patients were discharged within 3 weeks of UAE. One patient resumed menstruation in 6 months. NBCA may be a promising embolic material for emergent UAE in patients with PH, especially for patients with a coagulopathic condition.