# Interventional radiology for prevention and management of postpartum haemorrhage: a single centre retrospective cohort study

## TL;DR

This study shows that interventional radiology is effective and safe for preventing and managing postpartum haemorrhage, reducing the need for more invasive procedures.

## Contribution

The study provides new outcome data on the use of interventional radiology in peripartum settings for postpartum haemorrhage.

## Key findings

- Interventional radiology was successful in both prophylactic and therapeutic groups with low transfusion needs.
- Only 9.2% of patients required additional surgical interventions after interventional radiology.
- Most complications were minor, with severe complications occurring in just 3.9% of cases.

## Abstract

Postpartum haemorrhage (PPH) remains a leading cause of maternal death despite current medical management. Surgical interventions are still needed for refractory bleeding. Interventional radiology (IR) can be a successful intermediary that avoids the need for hysterectomy. Nevertheless, IR outcome data in a peripartum setting are limited. The objective of this study is to document the efficacy and safety of IR.

Retrospective study reviewed the records of consecutive patients who underwent peripartum IR from 01/01/2010 until 31/12/2020 in a tertiary academic centre. Patients were divided in a prophylactic and a therapeutic group. Information about interventions before and after IR, and IR specific complications was retrieved. Efficacy was defined by the number of transfusions and additional surgical interventions needed after IR, and safety was assessed by the incidence of IR related complications.

Fifty-four patients, prophylactic group (n = 24) and therapeutic group (n = 30), were identified. In both groups, IR was successful with 1.5 ± 2.9 packed cells transfused post-IR (1.0 ± 2.1 prophylactic vs 1.9 ± 3.3 therapeutic; p = 0.261). Additional surgical interventions were required in n = 5 patients (9.2%), n = 1 (4.2%) in the prophylactic vs. n = 4 (13.3%) in the therapeutic group. Complications were reported in n = 12 patients (22.2%), n = 2 (8.3%) prophylactic vs. n = 10 (33.3%) in therapeutic group. Mostly minor complications, as puncture site hematoma or bleeding, were reported in n = 4 (7.4%). Severe complications as necrosis and metabolic complications were reported in n = 2 patients (3.9%).

IR for prevention and treatment of PPH was highly successful and associated with minor complications.