Experience of a Colombian center in the endovascular management of postpartum hemorrhage that threatens life

Introduction: Postpartum hemorrhage is the leading cause of morbidity and mortality in the World. Lacerations are the second cause in frecuency. Early application of right management is the key to obtain adequate outcomes and vascular occlusion of pelvic vessels is counted among the management options. Objective: The purpose of our study was to describe the management experience with arterial embolization of pelvic vessels. Materials and methods: It is a retrospective case series study based in the institutional registry of Fundacion Valle del Lili (Cali, Colombia) which included patients with postpartum attended between January 1, 2011 and October 31, 2016. Results: Of 430 patients diagnosed with PPH, 11 were submitted to embolization of pelvic vessels. Within our group, 10 patients had vaginal delivery with complex vaginal lacerations; the majorities were referred from other less complex institutions after 20.5 hours. The frequently occluded arteries were the superior vaginal and the internal pudenda artery. No patient presented complications associated with the procedure and only 2 presented recurrent bleeding. 3 patients required hysterectomy but no patient died. Conclusion: Percutaneous management is a safe and efective Third line method for bleeding control with difficult management in the patients with postpartum hemorrhage after complex perineal tear. These results are similar to the case reports published in worldwide literature available at date.