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. 2023 Mar;102(3):370-377.
doi: 10.1111/aogs.14508. Epub 2023 Jan 26.

Interventional radiology in obstetric patients: A population-based record linkage study of use and outcomes

Heather J Baldwin  1   2 , Deborah A Randall  1   2 , Richard Maher  3 , Simon P West  4   5 , Siranda Torvaldsen  1   2   6 , Jonathan M Morris  1   2   4 , Jillian A Patterson  1   2
Affiliations

Interventional radiology in obstetric patients: A population-based record linkage study of use and outcomes

Heather J Baldwin et al. Acta Obstet Gynecol Scand. 2023 Mar.

Abstract

Introduction: Interventional radiology (IR) is a technique for controlling hemorrhage and preserving fertility for women with serious obstetric conditions such as placenta accreta spectrum (PAS) or postpartum hemorrhage. This study examined maternal, pregnancy and hospital characteristics and outcomes for women receiving IR in pregnancy and postpartum.

Material and methods: A population-based record linkage study was conducted, including all women who gave birth in hospital in New South Wales or the major tertiary hospital in the neighboring Australian Capital Territory, Australia, between 2003 and 2019. Data were obtained from birth and hospital records. Characteristics and outcomes of women who underwent IR in pregnancy or postpartum are described. Outcomes following IR were compared in a high-risk cohort of women: those with PAS who had a planned cesarean with hysterectomy. Women were grouped by those who did and those who did did not have IR and were matched using propensity score and other factors.

Results: We identified IR in 236 pregnancies of 1 584 708 (15.0 per 100 000), including 208 in the delivery and 26 in a postpartum admission. Two-thirds of women receiving IR in the birth admission received a transfusion of red cells or blood products, 28% underwent hysterectomy and 12.5% were readmitted within 6 weeks. Other complications included: severe maternal morbidity (29.8%), genitourinary tract trauma/repair (17.3%) and deep vein thrombosis/pulmonary embolism (4.3%). Outcomes for women with PAS who underwent planned cesarean with hysterectomy were similar for those who did and did not receive IR, with a small reduction in transfusion requirement for those who received IR.

Conclusions: Interventional radiology is infrequently used in pregnant women. In our study it was performed at a limited number of hospitals, largely tertiary centers, with the level of adverse outcomes reflecting use in a high-risk population. For women with PAS undergoing planned cesarean with hysterectomy, most outcomes were similar for those receiving IR and those not receiving IR, but IR may reduce bleeding.

Keywords: balloon occlusion catheterization; obstetric hemorrhage; pelvic arterial embolization; placenta accreta spectrum; postpartum hemorrhage; radiology.

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Conflict of interest statement

None.

References

    1. Ratnam LA, Gibson M, Sandhu C, Torrie P, Chandraharan E, Belli AM. Transcatheter pelvic arterial embolisation for control of obstetric and gynaecological haemorrhage. J Obstet Gynaecol. 2008;28:573‐579. - PubMed
    1. Viñas MT, Chandraharan E, Moneta M, Belli A. The role of interventional radiology in reducing haemorrhage and hysterectomy following caesarean section for morbidly adherent placenta. Clin Radiol. 2014;69:e345‐e351. - PubMed
    1. Peng Y, Jiang L, Peng C, Wu D, Chen L. The application of prophylactic balloon occlusion of the internal iliac artery for the treatment of placenta accreta spectrum with placenta previa: a retrospective case‐control study. BMC Pregnancy Childbirth. 2020;20:1‐8. - PMC - PubMed
    1. Ojala K, Perälä J, Kariniemi J, Ranta P, Raudaskoski T, Tekay A. Arterial embolization and prophylactic catheterization for the treatment for severe obstetric hemorrhage*. Acta Obstet Gynecol Scand. 2005;84:1075‐1080. - PubMed
    1. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists . Management of Postpartum Haemorrhage (PPH). The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. 2017.