[Management of severe post partum hemorrhage with embolization: the French experience].

PURPOSE: To gain a better understanding of the management of severe post partum hemorrhage in France.

PATIENTS AND

METHODS

A national survey of members of the Société Française d'Imagerie Cardio-Vasculaire (SFICV) and angiography units was performed in spring 2004.

RESULTS

A total of 465 (2002) and 497 (2003) embolizations were performed in 64 centers: 13 in Ile de France (Paris area), including 8 university hospitals (2002: 45% of all cases, 2003: 42.5%); 51 in the other French regions (24 university hospitals) (2002: 55% of all cases, 2003: 57.5%). In 2002, an average of 7.26 embolizations was performed in each center (0-36); in 2003: 7.77 (0-47). On call coverage was available in 77,6% of centers, with 1 to 8 participating radiologists (mean: 3.5). 98% of embolizations were performed in angio suites, located in the same building as the maternity ward for 53.4%, or 100m to 7km (mean: 1100m) with mean transfer time of 18 minutes (5 to 60 minutes).

CONCLUSION

Embolization is accurate and safe. When available, it should be considered as the first line treatment for validated indications. Multidisciplinary management of patients remains essential and protocols established by gynecologists, anesthesiologists and radiologists must be in place.