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| Clinical efficacy of uterine artery embolization for treating puerperae with refractory postpartum hemorrhage, and analysis of its related influencing factors |
| Rocket General Hospital, Beijing，100088 |
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Abstract Objective: To explore the clinical efficacy of uterine artery embolization for treating puerperae with refractory postpartum hemorrhage, and to analyze the influencing factors of surgical treatment failure. Methods: The clinical data of 121 puerperae with refractory postpartum hemorrhage who had admitted to rocket general hospital from June 2012 to June 2018 were retrospectively analyzed. All included patients had undergone uterine artery embolization. According to the result of treatment by uterine artery embolization, they were divided into treatment success group and treatment failure group. The general data and operation situation were compared between the two groups. Logistic regression was used to analyze the risk factors of treatment failure. Results: In the 121 patients, 110 (90.9%) cases were successfully treated and 11 (9.09%) were failed. Among the 11patients with treatment failure, 6 cases underwent total hysterectomy, and 5 cases were treated with uterine artery embolization again. In that 5 cases treated by uterine artery embolization again, the 4 cases were successfully treated and 1 case underwent total hysterectomy because of treatment failure again. Univariate analysis showed that puerperae with diffuse intravascular coagulation, scar uterus, injury of soft birth canal, placental factors, gestational complications, and combined use of uterotonics were risk factors for failure of uterine artery embolization. Multivariate logistic regression analysis showed that a puerpera with disseminated intravascular coagulation, scar uterus, gestational complications, or combined use of uterotonics was an independent risk factor for the failure of uterine artery embolization. Conclusion: Uterine artery embolization for treating puerperae with refractory postpartum hemorrhage is effective, has high success rate and good hemostasis efficacy. Disseminated intravascular coagulation, scar uterus, gestational complications, or combined use of uterotonics was an independent risk factor for the failure of uterine artery embolization to treat puerperae with diffuse intravascular coagulation,
so a reasonable treatment plan should be developed for such patients based on the patient's specific conditions.
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