Outcome of pregnancies after pelvic artery embolization for postpartum hemorrhage: retrospective cohort study
| Autor: | Andrew Yaeger, Yesmean Wahdan, Sarah H. Poggi, Alessandro Ghidini |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
medicine.medical_specialty animal structures Placenta accreta Birth weight Gestational Age Placenta Accreta Hysterectomy Pelvis Cohort Studies Young Adult Birth Intervals Pregnancy Recurrence Artery embolization Chart review medicine Birth Weight Humans Retrospective Studies Gynecology business.industry Obstetrics Medical record Postpartum Hemorrhage Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Gestational age Retrospective cohort study medicine.disease Embolization Therapeutic Case-Control Studies Cohort Female business |
| Zdroj: | American journal of obstetrics and gynecology. 213(4) |
| ISSN: | 1097-6868 |
| Popis: | Objective The effects of pelvic artery embolization (PAE) for postpartum hemorrhage (PPH) on subsequent pregnancies have been explored in small case series and one case-control study by mailed questionnaire with uncomplicated pregnancies as controls. We conducted a single-center retrospective cohort study using women with PPH without PAE for comparison. Study Design From a cohort of 103 women undergoing PAE for primary PPH between January 1999 and December 2012 (exposed) and 189 pregnancies with PPH not requiring PAE between January 2008 and December 2012 (unexposed), we queried the electronic medical records for readmissions to labor and delivery in subsequent years. Outcomes of subsequent pregnancies continuing past 20 weeks were obtained by chart review. Results Repeat pregnancies were documented in 17 of 103 exposed women (16.5%) and 18 of 189 unexposed women (9.5%). At delivery complicated by PPH, the groups did not differ in demographics, gestational age, units of blood transfused, or PPH cause. At the time of subsequent deliveries, there was a greater interdelivery interval in women exposed to PAE than those unexposed (1710 ± 938 days vs 904 ± 358 days; P = .002), and the 2 groups were similar in terms of gestational age and birthweight. However, there was a significantly higher rate of placenta accreta in exposed than unexposed women (23.5 % vs 0%; P = .04), with 3 of 17 sustaining total abdominal hysterectomy and 1 requiring repeat PAE for severe PPH. Conclusion Pregnancies following PAE for PPH were more likely than those not receiving PAE for treatment to be complicated by placenta accreta. Pregnancies following PAE should be followed up for imaging evidence of placenta accreta. |
| Databáze: | OpenAIRE |
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