F J Ruiz Labarta1, M P Pintado Recarte1, A Alvarez Luque2, L Joigneau Prieto1, L Perez Martín1, M Gonzalez Leyte2, F Palacio Abizanda3, F Morillas Ramirez3, A Perez Corral4, L Ortiz Quintana1, J De Leon-Luis5. 1. Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain. 2. Department of Radiology, Division of Interventional Radiology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain. 3. Department of Anaesthesiology and Critical Care, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain. 4. Department of Haematology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain. 5. Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain. Electronic address: jdeleonluis@yahoo.es.
Abstract
BACKGROUND: Postpartum haemorrhage (PPH) is an unpredictable obstetric emergency that requires a multidisciplinary approach. Pelvic arterial embolization (PAE) is considered as a second-line treatment, although the published results have not been reviewed systematically since 2007. OBJECTIVES: To evaluate success and complication rates of PAE to treat PPH in the study hospital between 2009 and 2015, and to perform a systematic review of the literature on the reported efficacy and safety of PAE for the management of PPH. SEARCH STRATEGY: A systematic review of articles on PAE in English or Spanish was conducted using Medline and the Cochrane Library. SELECTION CRITERIA: All published articles assessing success and complication rates of PAE in cases of PPH. The search was restricted to articles published in English or Spanish between 2000 and 2015, with at least 25 cases. DATA COLLECTION AND ANALYSIS: Obstetric variables, maternal haemodynamic state, pre-/postembolization management, technique-related variables, post-PAE evolution and complications were recorded in the case series study. Study characteristics, success rates and PAE-related complication rates were recorded in the systematic review. MAIN RESULTS: The case series included 29 patients. The majority of these patients were primiparous, with singleton term pregnancies and spontaneous labour. Caesarean section was performed in 62.1% of patients undergoing PAE for PPH. PAE was successful in 89.6% [95% confidence interval (CI) 78.3-100] of cases. Twenty studies were included in the systematic review, providing data from 1739 patients. PAE was successful in 89.4% (95% CI 87.9-90.9) of cases. The mortality rate was 0.9%, and other major complications were uncommon (1.8%). CONCLUSIONS: PAE was found to be a minimally invasive, highly successful and safe technique for the management of PPH. It should be considered in PPH refractory to initial treatment.
BACKGROUND: Postpartum haemorrhage (PPH) is an unpredictable obstetric emergency that requires a multidisciplinary approach. Pelvic arterial embolization (PAE) is considered as a second-line treatment, although the published results have not been reviewed systematically since 2007. OBJECTIVES: To evaluate success and complication rates of PAE to treat PPH in the study hospital between 2009 and 2015, and to perform a systematic review of the literature on the reported efficacy and safety of PAE for the management of PPH. SEARCH STRATEGY: A systematic review of articles on PAE in English or Spanish was conducted using Medline and the Cochrane Library. SELECTION CRITERIA: All published articles assessing success and complication rates of PAE in cases of PPH. The search was restricted to articles published in English or Spanish between 2000 and 2015, with at least 25 cases. DATA COLLECTION AND ANALYSIS: Obstetric variables, maternal haemodynamic state, pre-/postembolization management, technique-related variables, post-PAE evolution and complications were recorded in the case series study. Study characteristics, success rates and PAE-related complication rates were recorded in the systematic review. MAIN RESULTS: The case series included 29 patients. The majority of these patients were primiparous, with singleton term pregnancies and spontaneous labour. Caesarean section was performed in 62.1% of patients undergoing PAE for PPH. PAE was successful in 89.6% [95% confidence interval (CI) 78.3-100] of cases. Twenty studies were included in the systematic review, providing data from 1739 patients. PAE was successful in 89.4% (95% CI 87.9-90.9) of cases. The mortality rate was 0.9%, and other major complications were uncommon (1.8%). CONCLUSIONS:PAE was found to be a minimally invasive, highly successful and safe technique for the management of PPH. It should be considered in PPH refractory to initial treatment.
Authors: Audrey A Merriam; Yongmei Huang; Jason D Wright; Dena Goffman; Mary E D'Alton; Alexander M Friedman Journal: Obstet Gynecol Date: 2020-03 Impact factor: 7.623
Authors: Javier Ruiz-Labarta; Ana Martínez Martín; Pilar Pintado Recarte; Blanca González Garzón; Juan Manuel Pina Moreno; Mercedes Sánchez Rodríguez; África Vallejo Gea; Luis Sordo; Melchor Álvarez-Mon; Miguel A Ortega; Coral Bravo Arribas; Juan A De León-Luis Journal: Healthcare (Basel) Date: 2022-02-21
Authors: Francisco Javier Ruiz Labarta; María Pilar Pintado Recarte; Manuel González Leyte; Coral Bravo Arribas; Arturo Álvarez Luque; Yolanda Cuñarro López; Cielo García-Montero; Oscar Fraile-Martinez; Miguel A Ortega; Juan A De León-Luis Journal: J Pers Med Date: 2022-07-01
Authors: Anda-Petronela Radan; Sophie Schneider; Jarmila A Zdanowicz; Luigi Raio; Nando Mertineit; Johannes Thomas Heverhagen; Daniel V Surbek Journal: Life (Basel) Date: 2022-06-15
Authors: Francisco Javier Ruiz Labarta; María Pilar Pintado Recarte; Laura Joigneau Prieto; Coral Bravo Arribas; Julia Bujan; Miguel A Ortega; Juan A De León-Luis Journal: Healthcare (Basel) Date: 2021-03-08