Emergency IR · IR Playbook

Postpartum Hemorrhage Embolization (PPH)

Postpartum hemorrhage embolization is a uterus-sparing transcatheter treatment for persistent primary or secondary postpartum bleeding after prompt obstetric resuscitation and cause-directed first-line therapy. The usual strategy for uterine atony is bilateral uterine artery embolization with temporary absorbable gelatin sponge; focal arterial injury or pseudoaneurysm is treated superselectively with an agent matched to the lesion. CIRSE reports clinical success of 79–100%, repeat bleeding in 5–10%, and overall complication rates of 4–18%, while emphasizing that surgery must not be delayed when transfer or embolization would be unsafe.

What this playbook covers

• Indications
• Contraindications
• Pre-procedure
• Anatomy and Planning
• Equipment
• Procedure Steps
• Technical Endpoints
• Variants
• Comparisons
• Troubleshooting
• Complications
• Post-procedure Care
• References

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