Is there an association between postpartum hemorrhage, interventional radiology procedures, and psychological sequelae?

Abstract

Background

Postpartum hemorrhage (PPH) may cause post-traumatic psychological sequelae. Interventional radiology procedures (IRP) have been established in the management of PPH when conventional management fails. IRP is also used prophylactically in women who are at high risk for PPH in pregnancies with abnormally invasive placentation. We sought to determine if there is an association between PPH, IRP, and psychological sequelae.

Objectives

Seventy-three women who underwent IRP due to PPH or were at high risk for PPH.

Method

A structured questionnaire was sent to all women.

Results

Overall 49 women returned the questionnaire. Two-thirds of the women developed psychological sequelae and one-third reported a lack of professional support. Nine women had symptoms of post-traumatic stress disorder. Psychological sequelae were not associated with a volume of bleeding, whether or not hysterectomy was performed, or whether the IRP was performed as an emergency procedure or prophylactically. However, women who had elective IRP and no hysterectomy performed had significantly less fear of death compared to the rest of the study population.

Conclusions

We observed a high rate of psychological sequelae associated with IRP. Lack of proper professional support may have contributed to the development of post-traumatic psychological sequelae suggesting a need for debriefing in such women.

Keywords:

• Arterial embolization
• balloon occlusion of iliac arteries
• interventional radiology procedures
• long-term health impact
• postpartum hemorrhage

Acknowledgments

We acknowledge Professor Reynir Geirsson for critical review of the manuscript and Mrs. Maaria Puupponen for technical assistance.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Helsinki University Hospital Research Grants, by the Emil Aaltonen Foundation sr and by the Orion Research Foundation sr.