Purpose: To determine risk factors for post-partum hemorrhage (PPH) requiring emergent management with selective uterine artery embolization (UAE).
Material and Methods: An IRB-approved retrospective single-center study was conducted on 20 patients with PPH requiring UAE from 07/2014 to 05/2019. A control group was randomly selected consisting of 20 patients with significant PPH (defined as an estimated blood loss >1L) who were managed without UAE. Variables including patient demographics, gynecologic and obstetric history, labor and delivery characteristics, and administration of intraoperative therapeutic measures were compared between groups.
Results: Statistically significant risk factors favoring need for emergent UAE included multiparity (OR 6.0; p <0.05), past history of spontaneous or therapeutic abortion (OR 5.4; p <0.05), and prior Caesarian section (OR 6; p <0.05). Other variables which did not reach statistical significance but demonstrated positive odds ratios included prior PPH (OR 11.1, p = 0.11), multiple gestation (OR 3.35; p = 0.18) and magnesium sulfate administration (OR 3.86; p = 0.13).
Conclusions: Early identification of patients at high risk for severe PPH is vital for reducing maternal mortality. Although an increased risk of PPH in general has been associated with abnormal placentation, specific risk factors for PPH not likely to respond to intraoperative measures have not been well described. In this retrospective single-center study, these risk factors include multiparity, past history of spontaneous or therapeutic abortion, and prior Caesarian section.
