Uterine Artery Embolization Symbolizing Fertility

UAE: A Life-Saving Option in Obstetric Hemorrhage

Theo Raines in Health & Wellness December 2025 • 4 min read.

"Discover how Uterine Artery Embolization is changing the game for high-risk pregnancies and postpartum care."

Obstetrical hemorrhage has long been a critical concern in women's health. While medical interventions like utero-tonic agents have been the standard, severe cases often necessitate surgical procedures, including artery embolization or hysterectomy. Pelvic artery embolization, introduced in 1979, has grown in popularity as a method to preserve fertility, showcasing promising success rates over the last three decades.

Uterine Artery Embolization (UAE) is now recognized as a specialized, highly effective method to reduce obstetric hemorrhage. It is particularly valuable in cases of morbidly adherent placenta and accreta, where traditional surgical options may pose significant challenges.

This article sheds light on a case where UAE served as the primary treatment for obstetric hemorrhage in a patient at high risk for postpartum hemorrhage (PPH). Where surgical management was deemed unfeasible, UAE offered a viable solution. This approach reduces surgical blood loss, minimizes morbidity, and preserves the patient's fertility.

What Makes Uterine Artery Embolization a Game-Changer?

Uterine Artery Embolization Symbolizing Fertility

The case involves a 38-year-old female, gravida 3 para 1 living 1 abortion 1, with a history of one lower segment caesarean section. She presented at 38 weeks of gestation with a complete anterior placenta previa. Doppler studies were conducted to assess the possibility of an adherent placenta, but no evidence was found.

The patient's medical history was significant, including a recto-sigmoidectomy with an abdominal perineal pull-through performed 14 years prior. Her first delivery via caesarean section revealed substantial adhesions between the anterior abdominal wall and uterus, alongside a bladder injury during the previous surgery.

Complex Medical History: Prior surgeries created a high-risk scenario.
Placenta Previa: Complete placenta previa added to the risk of severe bleeding.
Adhesions: Extensive adhesions complicated surgical access and increased potential for complications.

Considering her surgical history and the presence of complete placenta previa, a planned repeat caesarean section with pre-operative uterine artery catheterization was scheduled. During the operation, the bladder was found to be completely adhered to the lower uterine segment. A low upper segment transverse incision was made through the anterior placenta, and the baby was successfully delivered. Immediately after delivery, the uterine artery balloons were inflated, significantly reducing bleeding at the incision site. Post-op fluoroscopy revealed hyper vascularity near the anterior division of the left-sided internal iliac artery. Selective embolization was performed.

The Future of Obstetric Care: UAE as a Key Procedure

In settings where endovascular catheterization facilities are available, pelvic artery embolization can significantly benefit patients at high risk for PPH who desire to preserve their fertility. When performed by skilled interventional radiologists, it stands as a valuable option.

About this Article -

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Everything You Need To Know

What is Uterine Artery Embolization (UAE), and how does it work in treating obstetric hemorrhage?

Uterine Artery Embolization (UAE) is a specialized medical procedure used to control severe bleeding during or after childbirth, known as obstetric hemorrhage. In this technique, interventional radiologists insert a catheter through a blood vessel and guide it to the uterine arteries. Once in place, they release embolic agents, which are small particles that block the blood flow to the uterus. This reduces or stops the bleeding, offering a life-saving alternative to traditional surgical interventions, such as hysterectomy, particularly in high-risk situations like those involving placenta accreta or morbidly adherent placenta. UAE helps preserve fertility and minimizes complications.

What are the advantages of Uterine Artery Embolization (UAE) over traditional treatments for postpartum hemorrhage (PPH)?

Compared to traditional methods like hysterectomy or surgical interventions, Uterine Artery Embolization (UAE) offers several advantages. UAE is minimally invasive, reducing surgical blood loss and recovery time. It is highly effective in controlling bleeding and, crucially, preserves the patient's fertility. Traditional treatments, especially hysterectomy, eliminate the possibility of future pregnancies. Furthermore, UAE can be particularly beneficial in complex cases where surgical options are challenging or pose a high risk of complications, such as patients with extensive adhesions or morbidly adherent placenta.

In what types of high-risk pregnancy scenarios is Uterine Artery Embolization (UAE) most beneficial?

Uterine Artery Embolization (UAE) is particularly valuable in high-risk pregnancy scenarios such as those involving placenta accreta and morbidly adherent placenta, conditions where the placenta grows too deeply into the uterine wall. It is also beneficial in cases of placenta previa, where the placenta covers the cervix, increasing the risk of severe bleeding. Furthermore, UAE can be effective for patients with a history of prior surgeries, such as caesarean sections or other pelvic procedures, which can create adhesions and complicate surgical access. In these situations, UAE offers a less invasive option to manage and control obstetric hemorrhage, preserving the patient's reproductive capabilities.

What specific challenges were present in the case study that made Uterine Artery Embolization (UAE) the preferred treatment?

In the presented case, several factors made Uterine Artery Embolization (UAE) the preferred treatment. The patient had a complex medical history, including a recto-sigmoidectomy and previous caesarean section, which led to extensive adhesions and complications. She also presented with complete anterior placenta previa, increasing the risk of severe bleeding during delivery. Because of the patient's surgical history and the location of the placenta, traditional surgical options were deemed high-risk. Therefore, the pre-operative uterine artery catheterization and subsequent UAE were selected as a safer and more effective strategy to control the bleeding.

How does the availability of endovascular catheterization facilities influence the use of Uterine Artery Embolization (UAE) in obstetric care?

The availability of endovascular catheterization facilities is crucial for the successful implementation of Uterine Artery Embolization (UAE) in obstetric care. UAE requires specialized equipment and the expertise of interventional radiologists who can perform the procedure. When these facilities and skilled personnel are accessible, UAE can significantly benefit patients at high risk for postpartum hemorrhage (PPH) who wish to preserve their fertility. Therefore, the presence of these resources expands the options for managing severe obstetric bleeding and enhances the quality of care for women with complex pregnancies. The availability of these facilities determines whether UAE can be offered as a viable treatment option.