{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:13:56Z","timestamp":1787019236999,"version":"build-2736575974"},"reference-count":48,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T00:00:00Z","timestamp":1715385600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>The objective of this study is to perform a meta-analysis comparing the effectiveness of uterine artery embolization (UAE) versus peripartum hysterectomy for acute refractory postpartum hemorrhage (PPH) control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>We systematically searched 6 medical databases for studies comparing UAE and hysterectomy in PPH. Outcomes examined were mortality, hospitalization duration (HD) in days, and red blood cells (RBC) units utilization. Statistical analysis used RevMan 5.1.7 and random-effects models. Odds ratios (OR) and mean differences (MDs) with 95% confidence intervals (CIs) were used for dichotomous and continuous outcomes, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We included 833 patients from 4 cohort studies, with 583 (70%) undergoing UAE. The UAE population required fewer RBC units (MD: \u22127.39; 95% CI: \u221214.73 to \u22120.04; p=0.05) and had shorter HD (MD: \u22123.22; 95% CI: \u22125.42 to \u22121.02; p=0.004). Lower mortality rates were noted for UAE in the pooled analysis, but no statistical significance. Uterine artery embolization demonstrated lower procedural complications (16.45% vs. 28.8%), in which UAE had less ureter and bladder lesions (OR: 0.05; 95% CI: 0.01-0.38; p=0.004 and OR: 0.02; 95% CI: 0.00-0.15;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt;0.001, respectively). Only 35 (6%) required conversion to hysterectomy, while 27 (4.6%) underwent re-embolization with 100% bleeding control. Uterine artery embolization did not hinder fertility, with normal menstruation restored in 19 patients with postoligomenorrhea.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Uterine artery embolization for the control of PPH is associated with lower use of RBC units and HD, but similar rates of mortality are noted when compared to hysterectomy. These results associated with uterine preservation could support its importance for refractory PPH management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>Uterine Artery Embolization is associated with a shorter hospitalization duration and reduced use of red blood cell units when compared with hysterectomy in refractory postpartum hemorrhage. Although demonstrating similar mortality rates, these findings, together with fertility preservation, support the method incorporation as a valuable option in obstetric services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028241252730","type":"journal-article","created":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T07:39:27Z","timestamp":1715413167000},"page":"78-87","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Uterine Artery Embolization Versus Hysterectomy in Postpartum Hemorrhage: A Systematic Review With Meta-Analysis"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9704-2466","authenticated-orcid":false,"given":"Miguel Godeiro","family":"Fernandez","sequence":"first","affiliation":[{"name":"Bahiana School of Medicine and Public Health (EBMSP), Salvador, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2980-7943","authenticated-orcid":false,"given":"Sarah Fernandez","family":"Coutinho de Carvalho","sequence":"additional","affiliation":[{"name":"Bahiana School of Medicine and Public Health (EBMSP), Salvador, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Almeida","family":"Martins","sequence":"additional","affiliation":[{"name":"Bahiana School of Medicine and Public Health (EBMSP), Salvador, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9492-6442","authenticated-orcid":false,"given":"Felipe da Silva Mota","family":"Santos","sequence":"additional","affiliation":[{"name":"University of Bahia State (UNEB), Salvador, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando Antonio Falc\u00e3o Paix\u00e3o","family":"Neto","sequence":"additional","affiliation":[{"name":"Cleriston Andrade General Hospital, Salvador, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malu Oliveira de Araujo","family":"Medeiros","sequence":"additional","affiliation":[{"name":"Bahiana School of Medicine and Public Health (EBMSP), Salvador, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Bastos Metzger","sequence":"additional","affiliation":[{"name":"CardioPulmonar Hospital \u2013 Rede D\u2019or, Salvador, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,5,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1636520"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14200"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.11.1287"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0000000000000273"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2016.1245135"},{"key":"e_1_3_2_7_2","volume-title":"Zugaib Obstetr\u00edcia","author":"Zugaib MFR","year":"2014","unstructured":"Zugaib MFR. Zugaib Obstetr\u00edcia. 4th ed. Barueri: Manole; 2014.","edition":"4"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-015-1054-y"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001736"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181e6df64"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/BMJ.N71"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2018.01.012"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/13645706.2018.1562943"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-018823"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10397-016-0936-6"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.09.003"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medin.2016.02.010"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgyn.2014.09.023"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.tvir.2017.10.007"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003249"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e3181cc406d"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2015.12.012"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2022.10.002"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.208.2.9680573"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9378(99)70045-4"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.177.6.1770145"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0301-2115(03)00249-7"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2003.08.007"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2006.12.010"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/den122"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2010.02.052"},{"key":"e_1_3_2_32_2","first-page":"511","article-title":"Uterine artery embolization for primary postpartum hemorrhage","volume":"11","author":"Kim TH","year":"2013","unstructured":"Kim TH, Lee HH, Kim JM, et al Uterine artery embolization for primary postpartum hemorrhage. Iran J Reprod Med. 2013;11:511\u2013518.","journal-title":"Iran J Reprod Med"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2020.1818218"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2017.07.034"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1590\/1677-5449.190149"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2022.01.004"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-013-9990-y"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-941444"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182841594"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-020-02622-2"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2012.12.002"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2013.03.014"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2021.12.004"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2010.09.031"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2017.09.003"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2012.09.029"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1672181"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2018.1497599"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-135"}],"container-title":["Journal of Endovascular Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028241252730","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15266028241252730","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028241252730","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:30:43Z","timestamp":1777498243000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15266028241252730"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,11]]},"references-count":48,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1177\/15266028241252730"],"URL":"https:\/\/doi.org\/10.1177\/15266028241252730","relation":{},"ISSN":["1526-6028","1545-1550"],"issn-type":[{"value":"1526-6028","type":"print"},{"value":"1545-1550","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,11]]}}}