Influence of Uterine Balloon Tamponade Prevalence on Uterine Artery Embolization in the Management of Postpartum Hemorrhage

TL;DR

This study found that using uterine balloon tamponade reduced the need for uterine artery embolization in treating postpartum hemorrhage, without affecting success rates.

Contribution

The study provides evidence on how the adoption of uterine balloon tamponade impacts the use of uterine artery embolization in postpartum hemorrhage management.

Findings

UAE use rate was significantly higher before UBT introduction (70.7% vs. 26.4%).

UAE success rates were similar between the pre-UBT and UBT periods.

Procedural time for UAE was longer in the UBT period but not significantly.

Abstract

Objectives: The aim of our retrospective cohort study was to assess the influence of uterine balloon tamponade (UBT) prevalence on uterine artery embolization (UAE) in management of postpartum hemorrhage (PPH). Methods: This retrospective cohort study analyzed, as the final cohort, women with PPH who were transferred from other hospitals or clinics and underwent UAE at our university hospital. Initial UAE success was defined as achieving hemostasis with the first UAE procedure. The use rates of UAE, UAE success rates, and UAE procedural times were compared between the pre-UBT period (January 2009–December 2014) and the UBT period (January 2015–December 2023). Results: In the pre-UBT period, 29 of 41 women with PPH underwent UAE. In the UBT period, 21 of 121 women received UAE following UBT, whereas 11 underwent UAE without prior UBT. The use rate of UAE was significantly higher in the pre-UBT period than in the UBT period (70.7% vs. 26.4%; p < 0.01). There were no significant differences in the initial (72.4% vs. 81.3%; p = 0.55) or final (82.8% vs. 87.5%; p = 0.72) success rates of UAE between the two periods. The procedural time of the initial UAE in the UBT period tended to be longer than that in the pre-UBT period (46 min vs. 61 min; p = 0.07). Conclusions: The introduction of UBT was associated with a reduced use rate of UAE, but it did not significantly affect the success rate or procedural time of UAE in the management of PPH.

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