| Fertility and pregnancy following pelvic arterial embolisation for postpartum haemorrhage. | |
| | |
MedLine Citation:
|
PMID: 19832826 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: To determine and compare the fertility and pregnancy outcomes following embolisation with or without uterine-sparing surgery for postpartum haemorrhage, and to attempt to identify specific risk factors associated with an increased likelihood of intrauterine synechia. DESIGN: Retrospective study. SETTING: University-affiliated tertiary referral centre. POPULATION: All consecutive women who had an embolisation with or without uterine-sparing surgery (vessel ligation and/or uterine compression) for postpartum haemorrhage between 1994 and 2007 were included. METHODS: Data were retrieved from medical files and telephone interviews. MAIN OUTCOME MEASURE(S): Fertility and pregnancy outcomes, synechia. RESULTS: Data were available for 68 of the 85 women (80%) included in the study. Among the 15 women who complained of amenorrhoea or decreased flow of menstruation, synechia was found in all those who decided to undergo an ambulatory hysteroscopy (n = 8). Seventeen women had 26 pregnancies with 19 term deliveries, one ectopic pregnancy, two abortions and four miscarriages. The clinical courses of the 19 complete gestations were uneventful, but postpartum haemorrhage recurred in six women (31.6%) (caused by placenta accreta in two women). Fertility and pregnancy outcomes did not differ between women who had undergone embolisation versus both embolisation and a uterine-sparing surgical procedure. The occurrence of synechia was significantly associated with a higher rate of placenta accreta/percreta (P < 0.001) and postpartum fever above 38.5 degrees C (P = 0.04). CONCLUSIONS: Embolisation, whether or not associated with a uterine-sparing surgical procedure, for postpartum haemorrhage does not appear to compromise a woman's subsequent fertility and obstetric outcome. Nevertheless, these women should be considered at high risk for postpartum haemorrhage during future deliveries. |
| | |
Authors:
|
Lo?c Sentilhes; A Gromez; E Clavier; B Resch; E Verspyck; L Marpeau |
Related Documents
:
|
484226 - Maternal sepsis, uterine rupture and coagulopathy complicating cervical cerclage. 2603916 - In vitro release of endothelium-derived relaxing factor by acetylcholine is increased d... 11393196 - Laparoscopic suture hysteropexy for uterine prolapse. 15042026 - Cesarean scar pregnancy: quantitative assessment of uterine neovascularization with 3-d... 15085886 - Amniotic fluid concentrations of collagenase-1 and collagenase-3 are increased in polyh... 12519046 - Ruptured heterotopic pregnancy: a report of unusual acute abdominal syndrome in two cases. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: BJOG : an international journal of obstetrics and gynaecology Volume: 117 ISSN: 1471-0528 ISO Abbreviation: BJOG Publication Date: 2010 Jan |
Date Detail:
|
Created Date: 2009-12-16 Completed Date: 2010-02-25 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
|
Languages: eng Pagination: 84-93 Citation Subset: AIM; IM |
Affiliation:
|
Department of Obstetrics and Gynaecology, Rouen University Hospital, Charles Nicolle, Rouen, France. loicsentilhes@hotmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Cohort Studies Embolization, Therapeutic / adverse effects* Female Gynatresia / etiology Humans Infertility, Female / etiology Placenta Accreta / etiology Postpartum Hemorrhage / therapy* Pregnancy Pregnancy Outcome Recurrence / prevention & control Risk Factors Tissue Adhesions / etiology Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Metabolic syndrome in young women with the polycystic ovary syndrome: revisiting the threshold for a...
Next Document: Indicators for intervention during the expulsive second-stage arrest of labour.