Risk factors for poor hemostasis of prophylactic uterine artery embolization before curettage in cesarean scar pregnancy

Autor: Hongan Tian, Shunzhen Li, Wanwan Jia, Kaihu Yu, Guangyao Wu
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal of International Medical Research, Vol 48 (2020)
Druh dokumentu: article
ISSN: 1473-2300
03000605
DOI: 10.1177/0300060520964379
Popis: Objective To observe the hemostatic effect of prophylactic uterine artery embolization (UAE) in patients with cesarean scar pregnancy (CSP) and to examine the risk factors for poor hemostasis. Methods Clinical data of 841 patients with CSP who underwent prophylactic UAE and curettage were retrospectively analyzed to evaluate the hemorrhage volume during curettage. A hemorrhage volume ≥200 mL was termed as poor hemostasis. The risk factors of poor hemostasis were analyzed and complications within 60 days postoperation were recorded. Results Among the 841 patients, 6.30% (53/841) had poor postoperative hemostasis. The independent risk factors of poor hemostasis were gestational sac size, parity, embolic agent diameter (>1000 μm), multivessel blood supply, and incomplete embolization. The main postoperative complications within 60 days after UAE were abdominal pain, low fever, nausea and vomiting, and buttock pain, with incidence rates of 71.22% (599/841), 47.44% (399/841), 39.12% (329/841), and 36.39% (306/841), respectively. Conclusions Prophylactic UAE before curettage in patients with CSP is safe and effective in reducing intraoperative hemorrhage. Gestational sac size, parity, embolic agent diameter, multivessel blood supply, and incomplete embolization of all arteries supplying blood to the uterus are risk factors of poor hemostasis.
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