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Master Thesis

Traitement des rétentions intra-utérines vascularisées symptomatiques par embolisation proximale des artères utérines avec gélatine résorbable

Abstract : Retained products of conception (RPOC) are a rare complication after pregnancy, miscarriage or abortion. Their management remains debated. Proximal uterine artery embolization (UAE) with gelatin sponge (GS) is widely used and efficient for delivery hemorrhages. The aim of this study was to investigate the efficacy and safety of proximal UAE for RPOC with vascular abnormalities (VA). It was a retrospective analysis of women suffering from genital bleeding after abortion, miscarriage or delivery with vascularized RPOC detected by US doppler. Unilateral or bilateral embolization with resorbable gelatin fragments was performed. The primary aim was to assess the effectiveness of embolization on genital bleeding. Secondary aims were to assess the effectiveness of embolization on ultrasound abnormalities at the US follow-up (W4), the rate of post-embolization curettage, the complications and the effect on fertility. From November 2017 to January 2021, 56 women aged 19 to 41 who presented with vaginal bleedings after abortion, miscarriage or delivery were analyzed. 24 women with symptomatic RPOC with VA were treated by proximal UAE and included in this study. The effectiveness of proximal UAE on genital bleeding was 100%. Five patients still had uterine retention at US follow-up, including 2 with vascular abnormalities. Among them, 2 benefited from hysteroscopy (one with curettage), 3 received a simple US follow-up. No major complication occurred. Four cases of minor complications were reported (one infectious endometritis, three post-embolization syndromes). Among the six patients who planned a pregnancy during the follow up, 5 got pregnant and reached the pregnancy to the end. Proximal UAE with resorbable gelatin fragments seems to be safe and effective for the management of symptomatic RPOC with VA and may be early proposed for patients with bleeding and stress to allow fast recovery.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03411960
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Tuesday, November 2, 2021 - 4:38:03 PM
Last modification on : Thursday, November 4, 2021 - 3:42:47 AM

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  • HAL Id : dumas-03411960, version 1

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Eliott Mathieu. Traitement des rétentions intra-utérines vascularisées symptomatiques par embolisation proximale des artères utérines avec gélatine résorbable. Médecine humaine et pathologie. 2021. ⟨dumas-03411960⟩

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