Bilateral uterine artery embolization

Sivagami^*

Assistant Nursing Superintendent, Kauvery Hospital, Salem, Tamil Nadu

*Correspondence

Introduction

Bilateral uterine artery embolization (UAE) is a minimally invasive procedure increasingly used to control sever uterine bleeding while preserving the uterus, especially in young patients. This case report describes the clinical presentation, diagnostic workup, management, and multidisciplinary nursing care of a young female patient who underwent bilateral UAE for uncontrolled uterine bleeding. The outcome highlights the effectiveness of timely intervention and comprehensive nursing care in achieving hemostasis, stabilizing the patient, and ensuring a safe recovery.

Severe uterine bleeding in young women can be life-threatening and requires prompt diagnosis and management. Uterine artery embolization is an effective alternative to surgical intervention, particularly in patients where fertility preservation is desired. This case emphasizes the medical and nursing aspects involved in the care of a young patient undergoing bilateral UAE.

History

A young female patient presented with a history of:

Acute onset of heavy vaginal bleeding
Associated symptoms of dizziness, weakness, and fatigue
No prior history of gynaecological surgery
Menstrual history suggestive of abnormal uterine bleeding.
No significant past medical illness

Relevant clinical findings

Pallor present
Tachycardia
Hypotension indicating hypovolemia
Active vaginal bleeding
Abnormal examination: mild lower abdominal tenderness
Signs suggestive of anemia

Relevant investigations

Complete blood count	reduced hemoglobin and hematocrit
Coagulation profile	within normal limits
Pelvic ultrasound	uterine pathology with increased vascularity
Doppler study	increased uterine arterial blood flow
Pregnancy test	negative

Angiogram findings

Selective Bilateral common iliac & internal iliac arteries done. Abnormal vascular blush from one of the cervical vaginal branches of left uterine artery noted which was super selectively cannulated with Micro catheter and embolized with PVA partial till complete vascular stasis. Bilateral internal iliac artery anterior disc branches embolized with gel foam procedure was uneventful. Right radial sheath care. Remove right radial sheath at 10.00pm

Procedure

11.2025 – Vacuum assisted vaginal delivery with RMLE
11.2025 – Bilateral uterine artery embolization

Investigation

PT	12.4
Control	13.0
INR	0.95
Serology	Negative

Date	Investigation	Value
25.11.2025	Haemoglobin	12.3
26.11.2025	Haemoglobin	10.5
27.11.2026	Haemoglobin	9.3
29.11.2026	Haemoglobin	8.4

Diagnosis

Severe abnormal uterine bleeding causing hemodynamic instability, requiring urgent intervention

Management

Immediate stabilization with intravenous fluids
Blood transfusion as indicated
Medical management with hemostatic agents
Multidisciplinary consultation involving gynecology and Interventional Radiology
Bilateral uterine artery embolization performed under imaging guidance
Post procedure monitoring in a high dependency /ICU setting.

Outcome

Successful control of uterine bleeding
Hemodynamic stabilization achieved
Improvement in haemoglobin levels
No immediate post-procedural complications.

Discharge

Patient discharged in stable condition
Advised oral medications including iron supplementation
Follow-up appointment scheduled with gynecology
Counselling provided regarding menstrual monitoring and warning signs

Discussion -Medical aspects

UAE is a safe and effective minimally invasive procedure for controlling severe uterine bleeding. It reduces the need for hysterectomy, particularly important in young patients. Early diagnosis, prompt intervention, and appropriate patient selection are crucial for favourable outcomes.

Discussion -Nursing aspects

Nursing care plays a vital role before and after UAE, including:

Continuous monitoring of vital signs
Assessment of bleeding and pain
Maintaining strict intake and output records
Monitoring puncture site for bleeding or hematoma
Patient education regarding post procedure care
Emotional support and reassurance

Conclusion

Bilateral uterine artery embolization is an effective uterus – preserving intervention for severe uterine bleeding in young patients. A coordinated multidisciplinary approach and Vigilant nursing care are essential in achieving optimal patient outcomes and ensuring a safe recovery.

Bilateral uterine artery embolization

Bilateral uterine artery embolization

Sivagami*

Nightingale Journals

Sivagami^*