Uterine Artery Embolization

SOC → SCF-DBI Logic Translation

Purpose

Uterine Artery Embolization (UAE) is a minimally invasive endovascular intervention performed to achieve targeted control of uterine hemorrhage through selective occlusion of uterine arterial inflow while preserving maternal physiology and, when feasible, reproductive potential.

In acute obstetric settings, UAE serves as an organ-preserving alternative to definitive surgical extirpation when hemodynamic conditions and institutional resources permit.

Under SCF-DBI, Uterine Artery Embolization is not merely arterial occlusion.

It is restoration of the Uteroplacental Hemostatic Preservation Network (UHPN) through precision modulation of uterine perfusion, interruption of hemorrhagic amplification, and preservation of reproductive resilience.

SOC Definition

Clinical Objective

Perform selective uterine arterial embolization to:

• Control active uterine hemorrhage
• Reduce transfusion requirements
• Preserve maternal hemodynamic stability
• Avoid hysterectomy when feasible
• Maintain organ perfusion
• Preserve future fertility potential
• Reduce procedural morbidity
• Improve maternal recovery

Applicable Cohort

Primary Postpartum Hemorrhage

Examples:

• Persistent bleeding after medical therapy
• Failure of uterine balloon tamponade
• Ongoing hemorrhage after conservative surgery
• Recurrent postpartum bleeding

Secondary Postpartum Hemorrhage

Examples:

• Delayed postpartum hemorrhage
• Pseudoaneurysm-related bleeding
• Arteriovenous malformations
• Persistent uterine bleeding after delivery

Placental Pathology

Examples:

• Placenta accreta spectrum following stabilization
• Placental implantation abnormalities
• Focal retained placental vascularity

Traumatic Hemorrhage

Examples:

• Cervical arterial bleeding
• Vaginal arterial injury
• Cesarean-related vascular injury
• Broad ligament vascular disruption

Fertility Preservation Scenarios

Examples:

• Hemodynamically stabilized patients
• Desire for uterine conservation
• Avoidance of hysterectomy when appropriate

SCF-DBI Translation

Core Concept

SOC views Uterine Artery Embolization as:

Selective endovascular occlusion of uterine arterial inflow to control hemorrhage.

SCF-DBI views Uterine Artery Embolization as:

Restoration of the Uteroplacental Hemostatic Preservation Network through targeted modulation of uterine perfusion while preserving maternal adaptive reserve and reproductive integrity.

The objective extends beyond cessation of bleeding.

The objective is preservation and restoration of:

1. Maternal hemostatic competence
2. Selective uterine perfusion control
3. Systemic circulatory resilience
4. Organ preservation
5. Reproductive potential
6. Long-term maternal adaptation

SCF-DBI Hemostatic Failure Architecture

Domain 1

Uteroplacental Hemostatic Preservation Failure

SOC Focus

Stop uterine bleeding.

SCF-DBI Focus

Interrupt hemorrhagic escalation while preserving uterine viability.

Failure Cascade

Obstetric vascular injury

↓

Persistent uterine hemorrhage

↓

Progressive blood loss

↓

Circulatory instability

↓

Transfusion escalation

↓

Coagulopathy evolution

↓

Organ hypoperfusion

↓

Reproductive sacrifice

↓

Maternal deterioration

SCF Classification

Uteroplacental Hemostatic Preservation Failure Syndrome (UHPFS)

A state in which persistent uterine hemorrhage overwhelms adaptive hemostatic and reproductive preservation systems.

Output

Uteroplacental Hemorrhage Severity Score (UHSS)

Domain 2

Selective Perfusion–Hemostasis Intelligence

Major SCF-DBI Enhancement

Selected Enhancement:

Selective Perfusion–Hemostasis Intelligence (SPHI)

This becomes the principal SCF-DBI enhancement for Uterine Artery Embolization.

Rationale

SOC evaluates:

• Angiographic bleeding control
• Technical success
• Rebleeding rates
• Need for hysterectomy

SCF-DBI evaluates:

Whether embolization restores hemostatic stability while preserving adaptive uterine function.

The central question becomes:

Has selective vascular modulation redirected maternal physiology from hemorrhagic collapse toward resilient recovery without unnecessary reproductive sacrifice?

Rescue Failure Cascade

Persistent arterial bleeding

↓

Incomplete embolization

↓

Recurrent hemorrhage

↓

Ongoing transfusion burden

↓

Hemodynamic deterioration

↓

Escalation to hysterectomy

↓

Functional loss

Rescue Recovery Cascade

Rapid angiographic identification

↓

Selective catheterization

↓

Targeted embolization

↓

Hemorrhage interruption

↓

Circulatory stabilization

↓

Transfusion reduction

↓

Uterine preservation

↓

Maternal recovery

Assessment Domains

Intelligence States

Output

Selective Perfusion–Hemostasis Score (SPHS)

Domain 3

Reproductive Preservation Intelligence

SCF-DBI Enhancement

Uterine conservation represents a major determinant of long-term resilience.

Assessment Domains

Output

Reproductive Preservation Score (RPS-UAE)

Domain 4

Circulatory Recovery Surveillance

SCF-DBI Enhancement

Hemorrhage control should restore systemic resilience.

Assessment Domains

Output

Circulatory Recovery Score (CRS)

Domain 5

Endovascular Resilience Intelligence

SCF-DBI Enhancement

The durability of minimally invasive hemostatic control determines procedural value.

Assessment Domains

Recovery States

Output

Endovascular Resilience Score (ERS-UAE)

Domain 6

Maternal Functional Recovery Readiness

SCF-DBI Enhancement

The endpoint extends beyond survival toward reintegration.

Assessment Domains

Readiness States

Output

Maternal Functional Recovery Score (MFRS)

Domain 7

RHENOVA Uteroplacental Preservation Matrix

SCF-DBI Enhancement

The objective is preservation of maternal survival through precision hemostasis and reproductive resilience.

Recovery Domains

Hemostatic Recovery

Reproductive Recovery

Functional Recovery

Output

RHENOVA Uteroplacental Preservation Score (RUPS)

RHENOVA Integration

R1 — Survival Preservation

Prevent:

• Maternal exsanguination
• Hemorrhagic shock
• Escalation to irreversible deterioration

Output:

Hemostatic Rescue Status

R2 — Recovery Optimization

Restore:

• Hemodynamic stability
• Selective perfusion control
• Adaptive reserve

Output:

Recovery Readiness Score

R3 — Regenerative Preservation

Protect:

• Uterine integrity
• Ovarian function
• Reproductive potential

Output:

Uteroplacental Preservation Profile

R4 — Functional Restoration

Achieve:

• Maternal recovery
• Maternal–infant reintegration
• Preservation of reproductive autonomy

Output:

Maternal Restoration Matrix

R5 — Long-Term Resilience

Prevent:

• Recurrent hemorrhage
• Unnecessary hysterectomy
• Chronic reproductive sequelae
• Persistent maternal disability
• Psychosocial deterioration

Output:

Uteroplacental Resilience Profile

SCF-DBI Uterine Artery Embolization Workflow

Step 1

Identify Uteroplacental Hemostatic Preservation Failure.

Output

Uteroplacental Hemorrhage Severity Score.

Step 2

Activate obstetric hemorrhage response and perform selective uterine artery embolization.

Output

Uteroplacental Hemostatic Preservation Network Restoration Confirmation.

Step 3

Initiate Selective Perfusion–Hemostasis Intelligence.

Output

Selective Perfusion–Hemostasis Score.

Step 4

Assess reproductive preservation.

Output

Reproductive Preservation Score.

Step 5

Evaluate circulatory recovery.

Output

Circulatory Recovery Score.

Step 6

Assess endovascular resilience and maternal functional readiness.

Output

Endovascular Resilience Score and Maternal Functional Recovery Score.

Step 7

Generate the RHENOVA Uteroplacental Preservation Matrix.

Output

RHENOVA Uteroplacental Preservation Score.

Glossary

SCF Principle Alignment

INDEX

SCF-OB-UTERINE-ARTERY-EMBOLIZATION-0001

SCF-DBI-UTEROPLACENTAL-HEMOSTATIC-PRESERVATION-NETWORK-0001

SCF-DBI-UTEROPLACENTAL-HEMOSTATIC-PRESERVATION-FAILURE-SYNDROME-0001

SCF-DBI-SELECTIVE-PERFUSION-HEMOSTASIS-INTELLIGENCE-0001

SCF-DBI-SELECTIVE-PERFUSION-HEMOSTASIS-SCORE-0001

SCF-DBI-REPRODUCTIVE-PRESERVATION-SCORE-UAE-0001

SCF-DBI-CIRCULATORY-RECOVERY-SCORE-0001

SCF-DBI-ENDOVASCULAR-RESILIENCE-SCORE-UAE-0001

SCF-DBI-MATERNAL-FUNCTIONAL-RECOVERY-SCORE-0001

SCF-DBI-RHENOVA-UTEROPLACENTAL-PRESERVATION-MATRIX-0001

SCF-UTERINE-ARTERY-EMBOLIZATION-WORKFLOW-0086

SCF-UTERINE-ARTERY-EMBOLIZATION-MASTER-0001