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Human Reproduction, Vol. 18, No. 4, 849-852, April 2003
© 2003 European Society of Human Reproduction and Embryology

Fertility and pregnancy outcome following pelvic arterial embolization for severe post-partum haemorrhage. A cohort study

L.J. Salomon1, R. de Tayrac1, V. Castaigne-Meary1, F. Audibert1, D. Musset2, R. Ciorascu2, R. Frydman1 and H. Fernandez1,3

Service de 1 Gynécologie-Obstétrique and 2 Radiologie, Hôpital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, 157 rue de la Porte-de-Trivaux, 92141 Clamart cedex, France

3 To whom correspondence should be addressed. e-mail: herve.fernandez{at}abc.ap-hop-paris.fr

BACKGROUND: Pelvic arterial embolization is a safe, effective life-saving procedure in post-partum haemorrhage, but little information is yet available about its impact on menstruation and fertility. METHODS: A cohort of 28 women who underwent pelvic embolization for post-partum haemorrhage in our tertiary centre was studied. Patients were contacted by telephone to obtain long-term outcome for menstruation, clinical signs of estrogen insufficiency, desire for fertility and subsequent pregnancies. RESULTS: We found no menstrual abnormalities or signs of early menopause among the 17 patients we were able to reach. Six women expressed a clear desire for subsequent pregnancies. Five patients reported a total of six pregnancies (one biochemical pregnancy, one early miscarriage and four deliveries). The four patients with complete gestations gave birth to healthy babies, but post-partum haemorrhage recurred for all and led to two hysterectomies. No undesired pregnancies occurred. CONCLUSIONS: Embolization in post-partum haemorrhage appears to be a safe procedure that does not impair subsequent menstruation and fertility. Recurrence of severe post-partum haemorrhage may occur at subsequent deliveries.

Key words: embolization/fertility/menstruation/post-partum haemorrhage/pregnancy


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