%0 Journal Article %T Serious primary post-partum hemorrhage, arterial embolization and future fertility: a retrospective study of 46 cases. %+ Groupe de recherche sur la thrombose, pharmacologie des antithrombotiques et situations à risque (GRT) %+ Laboratoire de Biophotonique et Pharmacologie - UMR 7213 (LBP) %A Chauleur, C. %A Fanget, C. %A Tourne, G. %A Levy, R. %A Larchez, C. %A Seffert, P. %< avec comité de lecture %@ 0268-1161 %J Human Reproduction %I Oxford University Press (OUP) %V 23 %N 7 %P 1553-9 %8 2008-07 %D 2008 %R 10.1093/humrep/den122 %M 18460450 %Z Life Sciences [q-bio]/Pharmaceutical sciences/PharmacologyJournal articles %X BACKGROUND: The guidelines advise arterial embolization in case of post-partum hemorrhage. We evaluated its feasibility and the subsequent fertility. METHODS: A retrospective study has been conducted in our center for the past 10 years (1996-2005). Fifty-two patients experiencing a primary post-partum hemorrhage who were resistant to medical treatment underwent uterine artery embolization and/or hysterectomy. In case of arterial embolization, a follow-up of all the patients was realized, focusing on the preservation of fertility. RESULTS: Six (11.5%) patients underwent hysterectomy straightaway and 46 (88.5%) arterial embolization in the first instance including 35 arterial embolizations after Cesarean section. Embolization was successful among 41 patients (89.1%) and hysterectomy was performed on the 5 (10.9%) others. Overall, 11/24 398 women suffered from a definitive loss of fertility after post-partum hemorrhage. Fertility was studied at least 1 year after the delivery. All patients had a return of normal menses. Sixteen of 41 women (39%) wanted another child and 100% succeeded. Nineteen pregnancies, including two twin pregnancy and one early spontaneous abortion were observed. CONCLUSIONS: Embolization is a safe and effective non-surgical method to resolve post-partum hemorrhage and should be regarded as gold standard in a hemodynamically stable patient. Furthermore, subsequent fertility is not impaired by the procedure. %G English %L ujm-00440351 %U https://ujm.hal.science/ujm-00440351 %~ UNIV-ST-ETIENNE %~ CNRS %~ UNIV-STRASBG %~ SITE-ALSACE %~ UDL %~ TEST3-HALCNRS