Uterine artery embolization versus surgical management in primary atonic postpartum hemorrhage: A random

Background: Postpartum hemorrhage is the leading cause of severe maternal morbidity and death. A prompt management of uterine atony is life saving. Surgery can be needed in many cases. Uterine artery embolization (UAE) is a safe procedure and can be tried to be alternative to surgical approach. Objective: To evaluate the clinical effectiveness and safety of uterine artery embolization (UAE) in comparison with stepwise devascularization and compression sutures in the treatment of postpartum hemorrhage (PPH). Methods: Randomized controlled parallel-group trial included twenty-three women with postpartum hemorrhage who were treated with either selective embolization of the uterine arteries or stepwise devascularization and compression sutures after failure of conservative measures. Results: Technical success was achieved in 9 patients (81.8%) of cases with complete cessation of the bleeding, while 2 cases (18.2%) suffered DIC and needed hysterectomy in the UAE group, while the other group (12 patients) had stepwise devascularization and compression sutures done after failure of the conservative measures, with 3 cases who needed hysterectomy after failure of these methods. Conclusions: Uterine artery embolization is a safe, minimally invasive and effective method for treatment of postpartum hemorrhage and is alternative to surgical management