What is Postpartum Hemorrhage and Uterine Artery Embolization?
Postpartum hemorrhage is excessive bleeding after giving birth. It usually happens right after delivery but can also happen days later.
There are many causes of postpartum hemorrhage. The most common cause is weak muscles of the uterus, or womb. Normally the muscles of the uterus tighten up, or contract, right after giving birth. This helps squeeze the blood vessels in the uterus to stop them from bleeding. Sometimes the uterus muscles do not contract enough. This allows the blood vessels in the uterus to keep bleeding and can be life-threatening.
Uterine artery embolization (UAE) is a minimally invasive procedure to stop the bleeding. It involves injecting special material into the blood vessels feeding the uterus to block them and stop the bleeding.
How is Uterine Artery Embolization done?
You will be given medicine to help you relax. The skin on your wrist or upper thigh will be cleaned and numbed. Your clinician will thread a thin tube through a pinhole in the skin into a blood vessel. They will use x-rays and dye to guide the tiny tube to the blood vessels feeding the uterus. They will inject special material through the tube to block off some of the blood vessels and stop the bleeding. They will remove the tube and put a dressing over the pinhole where the tube entered the skin.
Uterine Artery Embolization
1. After numbing the skin, a small tube is placed into the blood vessel at the top of the thigh (shown) or wrist.
2. Using x-rays, the clinician guides the tube to the artery in the uterus that is bleeding and injects special material to stop the bleeding.
3. After, the clinician removes the tube and places a bandage over the pinhole in the skin.
What are the risks?
Uterine artery embolization is generally a safe procedure when done by a specialist.
Postpartum hemorrhage is a dangerous condition that carries the risk of complications with or without intervention. These include damage to the heart, kidneys, or liver. It can also cause fluid to build up in the lungs.
6-9 in 100 people
develop infection or damage to the uterus that may require surgery
experience bleeding or damage to the blood vessels
The procedure can also make it more difficult to have a child in the future. It does NOT affect sexual function.
What are the alternatives?
Your treatment options depend upon your preferences, overall health and unique healthcare conditions.
Alternative 1 Medicines are often tried first to make the uterus contract and stop the bleeding. Your clinician may also try massaging the uterus to help it contract.
Alternative 2 Balloon and pressure inside the uterus. The cavity of the uterus can be packed with sponges or filled with a special balloon to apply pressure and stop the bleeding.
Alternative 3 Surgery to stop the bleeding by tying off the blood vessels feeding the uterus. The uterus can also be removed, called a hysterectomy. Surgery tends to have more complications and takes longer for you to recover. It is not possible to get pregnant after hysterectomy.