Background: To evaluate role of endovascular IR procedures in obstetric emergencies. Method(s): In this ethically approved study a total of 33 patients presenting with obstetric
emergencies were recruited during the period September 2017 to October 2018 after
taking informed consent. The clinical success and complications were evaluated. Result(s): The spectrum of obstetric emergencies encountered were uterine arteriovenous malformations
in 13 (40%) patients, retained products of conception or retained adherent placenta
in 8 (24%), placenta accreta in 8 (24%), retained products of conception with secondary
arteriovenous malformations in 3 (9%) patients, and pseudoaneurysm in 1 (3%) patient.
A total of 28 uterine artery embolizations (repeat procedure required in 3 patients)
were performed with clinical success in all the patients. Prophylactic intraoperative
balloon occlusion of bilateral internal iliac arteries was done in 8 patients with
suspected placenta accreta. Of these 3 patients (37.5%) had focal placenta accreta
which separated after delivery of baby whereas the remaining 5 (62.5%) patients underwent
hysterectomy with mean intraoperative blood loss of 3.31 (0.8- 6.8) litres and relative
ease of hysterectomy for surgeons. There were no major complications, however minor
complications were seen in 10 (30%) patients. These included periprocedural pain in
3 (9%) patients, post embolization syndrome in 5 (15%) patients and puncture site
hematoma in 2 (6%) patients. All these resolved on conservative management. Conclusion(s): Interventional radiological procedures are helpful in obstetric emergencies with
significant clinical success rate and low complication rate.
