GRAND RAPIDS, Mich. — A new study suggests early intervention with a minimally invasive treatment can reduce the number of hysterectomies due to postpartum hemorrhaging.
“These findings are important and may help more women avoid hysterectomy and other very serious complications of uncontrolled hemorrhage,” said Dr. Younes Jahangiri, an interventional radiologist resident at Corewell Health.
Jahangiri and Dr. Jim Morrison, who oversees Corewell’s interventional radiology program, co-authored the study.
According to the World Health Organization (WHO), annually, 14 million women worldwide experience severe bleeding after childbirth, resulting in 70,000 deaths.
“This is a pretty serious issue and unfortunately, in the recent years, the numbers have been increasing in the United States,” said Jahangiri.
Obstetricians treat postpartum hemorrhage with blood transfusions, massages and medications, but if those measures fail, they usually perform hysterectomies; however, Jahangiri and Morrison’s study indicates uterine artery embolizations (UAE), a minimally invasive treatment that uses a temporary plug to stop the bleeding, may give women an option that does not take away their ability to carry children.
“Having done a number of these procedures myself, it seemed like we were doing enough of this that we wanted to take a retrospective look at our outcomes,” said Morrison. “See how effective we’ve been, and then, use that information to better understand those scenarios [and answer] where [and] when we should get involved.”
Jahangiri and Morrison analyzed 66 patients who underwent UAE between 2014 and 2022.
They concluded the procedure successfully controlled postpartum hemorrhage in 94 percent of the cases. The four women who still needed hysterectomies lost more than 2,400 ml of blood prior to UAW, which Morrison says gives doctors key insight into the condition.
“What we were able to show, I think, for the first time is that there is kind of a cutoff, and after that point, [UAE] is less effective,” said Morrison. “We can point to that [2,400 ml level] and say, ‘Okay, if the patient has met this criteria, before we get to that point, we want to be called to intervene.”
Jahangiri adds they plan to expand their research to include multiple institutions and ultimately conduct a prospective study that examines longer-term outcomes of UAE. He hopes in the meantime, the study encourages OBGYNs to include interventional radiologists in the postpartum process so women may keep their physical and emotional health intact.
“The uterus-preserving treatment can be very effective in both preserving their fertility in the future and also avoiding psychosocial effects of losing uterus,” said Jahangiri.
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