Obstetric embolotherapy: effect on menses and pregnancy

Abstract

Purpose: To determine the long-term effects of uterine embolotherapy with gelatin sponge pledgets on menses and fertility.

Materials and methods: Between June 1990 and December 1995, 17 women (aged 20-44 years) with obstetric hemorrhage underwent selective gelatin sponge pledget embolization of uterine vessels. Gynecologic information in the 12 women who did not undergo hysterectomy was obtained by means of direct communication or from the patients' physicians.

Results: In 11 (92%) of the 12 women, normal menses resumed within 2-5 months of the procedure. There were no complications related to embolotherapy. The follow-up period was 1-6 years. All three patients who desired to conceive had full-term, healthy newborns. The only patient who is amenorrheic is currently receiving medroxyprogesterone acetate; her ultimate menstrual and fertility status cannot yet be determined.

Conclusion: Selective embolization of the uterine vessels with gelatin sponge pledgets is a safe and effective method of managing pregnancy-related hemorrhage. Our results suggest that women who undergo this procedure can expect to have a return of normal menses with no adverse effect on fertility.