Treatment Patterns for Postpartum Hemorrhage Examined
Hysterectomy used more often for clinically significant PPH despite shorter hospital stays, lower costs with uterine artery embolization
FRIDAY, March 26, 2021 (HealthDay News) -- For women with clinically significant postpartum hemorrhage (PPH), uterine artery embolization (UAE) results in reduced hospital stay and costs compared with hysterectomy, according to a study presented at the annual meeting of the Society of Interventional Radiology, held virtually from March 20 to 26.
Linzi Ardnt, from Emory University in Atlanta, and colleagues used the U.S. Healthcare Cost and Utilization Project Nationwide Inpatient Sample database to examine the utilization and comparative effectiveness of various therapies for patients with clinically significant PPH, defined as those receiving a blood transfusion, blood transfusion plus hysterectomy, or UAE.
The researchers found that the overall incidence of PPH was 31.0 per 1,000 live births among 9.8 million live births. Transfusion was the most common intervention for PPH (average incidence, 116.4 per 1,000 cases of PPH). The incidence of hysterectomy was significantly greater than that of UAE for treating PPH (20.4 versus 12.9 per 1,000 cases). Race, maternal age, year of admission, previous or current cesarean section, breech position of fetus, placenta previa, preexisting hypertension, and preeclampsia were included as factors associated with type of therapy received. The likelihood of mortality was increased with hysterectomy versus UAE; however, after adjustment for propensity matching, the difference was attenuated. Prolonged hospital stay was significantly (2.1 times) more likely after hysterectomy versus UAE; UAE also resulted in reduced costs and allowed the opportunity to preserve fertility.
"All patients should have consistent access to a treatment that is safer, has an easier recovery, and could preserve their ability to continue to have children," a coauthor said in a statement.