Abstract：
OBJECTIVE: To evaluate angiographic findings and outcomes of repeat uterine artery embolization (UAE) for recurrent postpartum hemorrhage (PPH) in patients who previously underwent UAE for PPH after a previous delivery.
METHODS: Among 1805 patients who underwent UAE for PPH from 2007 to 2020 at four participating hospitals, the data of 21 (1.16%) patients who underwent UAE for PPH after subsequent delivery were collected and analyzed retrospectively. The rate of placental abnormalities, causes of PPH, angiographic findings, and clinical success rate were evaluated.
RESULTS: The technical success rates were 100% and 95.2%, and clinical success rates were 85.7% and 95.2% in association with first and second UAEs, respectively. The time intervals between first and second UAEs ranged from 15.6 to 103.3 months (46.5 ± 25.0 months). The rate of placental abnormalities was significantly higher in association with second UAEs than with first UAEs (71.4% vs. 42.8%, p = 0.034). The causes of PPH were different between first and second UAEs with borderline significance (p = 0.049); uterine atony (81.0%) and placenta accreta spectrum (57.1%) were most common in association with first and second UAEs, respectively. During second UAEs, obliterated arteries were observed in 27 uterine arteries (27/42, 64.3%) of 16 patients (16/21, 76.2%), with partial obliteration predominating over total obliteration. Collateral arteries were observed in 15 patients during second UAEs.
CONCLUSIONS: Repeat UAE is safe and effective for recurrent PPH after subsequent delivery in patients with prior UAE. Obliteration of UAs and formation of collateral arteries are common at the second UAEs.
CONCLUSIONS: • The rate of placental abnormalities was significantly higher in association with second UAEs than with first UAEs (71.4% vs. 42.8%, p = 0.034). • Obliteration of UAs and formation of collateral arteries are common at the second UAEs. • Repeat UAE is safe and effective for recurrent PPH after subsequent delivery in patients with prior UAE.
METHODS: Among 1805 patients who underwent UAE for PPH from 2007 to 2020 at four participating hospitals, the data of 21 (1.16%) patients who underwent UAE for PPH after subsequent delivery were collected and analyzed retrospectively. The rate of placental abnormalities, causes of PPH, angiographic findings, and clinical success rate were evaluated.
RESULTS: The technical success rates were 100% and 95.2%, and clinical success rates were 85.7% and 95.2% in association with first and second UAEs, respectively. The time intervals between first and second UAEs ranged from 15.6 to 103.3 months (46.5 ± 25.0 months). The rate of placental abnormalities was significantly higher in association with second UAEs than with first UAEs (71.4% vs. 42.8%, p = 0.034). The causes of PPH were different between first and second UAEs with borderline significance (p = 0.049); uterine atony (81.0%) and placenta accreta spectrum (57.1%) were most common in association with first and second UAEs, respectively. During second UAEs, obliterated arteries were observed in 27 uterine arteries (27/42, 64.3%) of 16 patients (16/21, 76.2%), with partial obliteration predominating over total obliteration. Collateral arteries were observed in 15 patients during second UAEs.
CONCLUSIONS: Repeat UAE is safe and effective for recurrent PPH after subsequent delivery in patients with prior UAE. Obliteration of UAs and formation of collateral arteries are common at the second UAEs.
CONCLUSIONS: • The rate of placental abnormalities was significantly higher in association with second UAEs than with first UAEs (71.4% vs. 42.8%, p = 0.034). • Obliteration of UAs and formation of collateral arteries are common at the second UAEs. • Repeat UAE is safe and effective for recurrent PPH after subsequent delivery in patients with prior UAE.
摘要：
目的：评估反复子宫动脉栓塞术(UAE)治疗复发性产后出血(PPH)的患者在分娩后接受UAE术的血管造影结果和结局。
方法：在2007年至2020年在四家参与医院接受PPH的1805例患者中，我们收集并回顾性分析了21例(1.16%)在随后分娩后接受了PPHUAE的患者的数据.胎盘异常的发生率，PPH的原因，血管造影结果,并对临床成功率进行评价。
结果：技术成功率分别为100%和95.2%，与第一次和第二次UAE相关的临床成功率分别为85.7%和95.2%，分别。第一次和第二次UAE之间的时间间隔为15.6至103.3个月(46.5±25.0个月)。与第二次UAE相关的胎盘异常率显着高于第一次UAE（71.4％vs.42.8%,p=0.034)。PPH的原因在第一次和第二次UAE之间是不同的，具有临界意义（p=0.049）;子宫收缩乏力（81.0％）和胎盘植入谱（57.1％）与第一次和第二次UAE相关最常见，分别。在第二次UAE期间，16例(16/21,76.2%)患者中27条(27/42,64.3%)子宫动脉闭塞,部分消除率高于全部消除率。在第二次UAE期间在15例患者中观察到侧支动脉。
结论：重复UAE对于既往UAE患者后续分娩后的复发性PPH是安全有效的。在第二个UAE中，UA的闭塞和侧支动脉的形成很常见。
结论：•与第二次UAE相关的胎盘异常率显着高于第一次UAE（71.4％vs.42.8%,p=0.034)。•在第二UAE处,UA的闭塞和侧支动脉的形成是常见的。•重复UAE对于先前UAE患者随后分娩后的复发性PPH是安全有效的。
方法：在2007年至2020年在四家参与医院接受PPH的1805例患者中，
结果：技术成功率分别为100%和95.2%，
结论：重复UAE对于既往UAE患者后续分娩后的复发性PPH是安全有效的。
结论：•与第二次UAE相关的胎盘异常率显着高于第一次UAE（71.4％vs.
