Bibliographic information
GuidelineConsolidated guidelines for the prevention, diagnosis and treatment of postpartum haemorrhage
Year of Publication2025
Issuing InstitutionWorld Health Organization
Recommendation
New
If other measures have failed and if the necessary resources are available, the use of uterine artery embolization is recommended as a treatment for postpartum haemorrhage due to uterine atony
Context specific recommendation
Only in specific contexts
Notes and Remarks
- Uterine artery embolization is a highly specialized procedure that requires the availability of interventional radiology services, including trained personnel, appropriate imaging equipment and around-the-clock access. This limits its use to well-resourced, typically tertiary care facilities.
- The GDG noted that timely access is critical to the success of uterine artery embolization; delays in performing the procedure may reduce its effectiveness or increase the risk of adverse outcomes. Therefore, when uterine artery embolization is being considered, parallel preparations for surgical alternatives should not be delayed.
- Where the procedure is available, it may offer fertility-preserving advantages compared to hysterectomy. The GDG recognized this as an important consideration for some women, especially those who desire future pregnancies.
- The procedure is not a replacement for prompt initial treatment, including the PPH first-response bundle. It should be reserved for use after failure of medical and mechanical interventions or when surgical options carry a high risk.
- The GDG noted that uterine artery embolization requires significant resources, in terms of the cost of the treatment, the facilities and the training of health care workers. Health systems considering uterine artery embolization as part of their PPH treatment strategy should invest in protocols to ensure timely referral and coordinated care between obstetrics, anaesthesia and interventional radiology teams.