Uterine Artery Embolization Versus Hysterectomy in Postpartum Hemorrhage: A Systematic Review With Meta-Analysis.

This study systematically compares uterine artery embolization (UAE) and peripartum hysterectomy for controlling acute refractory postpartum hemorrhage (PPH). Analyzing data from four cohort studies involving 833 patients, the meta-analysis found that UAE is associated with reduced red blood cell transfusion requirements and shorter hospitalization duration compared to hysterectomy, while mortality rates were similar between the two procedures. UAE also demonstrated fewer procedural complications, particularly lower rates of ureter and bladder injuries, and preserved fertility with restoration of normal menstruation in affected patients. These findings suggest that UAE is an effective, uterus-preserving alternative to hysterectomy for managing refractory PPH, supporting its incorporation into obstetric care where interventional radiology resources are available.