Abstract: Objective To evaluate the clinical advantages, method selection, efficacy and safety of pelvic arterial embolization(PAE)in the treatment of postpartum hemorrhage(PPH). Methods Clinical data of 46 PPH cases who received PAE in our hospital during Jan. 2016 and Jan. 2018 were retrospectively analyzed. The clinical operating characteristics and effectiveness of PAE, short- and long-term complications and re-fertility outcomes were evaluated. Results Among the 46 cases,24 had virginal delivery and 22 received cesarean section.The most frequent cause of PPH was placental problems(63.04%), followed by uterine atony(52.17%), uterine arteriovenous malformation(8.70%), and genital tract trauma(4.35%). Eight cases had combined causes. All 46 patients received one or more interventions before PAE, and PAE was performed when these interventions failed. Altogether 133 arteries received PAE, including bilateral uterine arteries in 27 cases, bilateral internal iliac arteries in 1 case, bilateral uterine arteries and bilateral iliac arteries in15 cases, bilateral inferior epigastric arteries in 1 case,bilateral ovarian arteries in 1 case, and bilateral uterine arteries, bilateral internal iliac arteries, and right ovarian artery in 1 case. Altogether 51 PAE were performed, and the overall technical success rate was 100%(51/51). Of all 46 patients, 3 had no effective relief after the first PAEand had to receive asecond one; 1 received 3 consecutive PAE; 1 received hysterectomy after PAE failed. The clinical success rate was 88.23%(45/51). Fever occurred in 6 patients after PAE. Of the 42 patients who were followed up, 39(92.86%)resumed normal menses, 3(7.14%)reported amenorrhea, and 7(16.67%)had pregnancy again. Conclusion PAE is effective and safe in the treatment of postpartum hemorrhage.

Key words: Postpartum hemorrhage, Pernicious placenta previa, Pelvic arterial embolization, Treatment outcome