Efficacy of pelvic artery embolisation for severe postpartum hemorrhage

Spreu, A; Abgottspon, Florian; Baumann, Marc; Kettenbach, Joachim; Surbek, Daniel

doi:10.1007/s00404-017-4554-y

Cited by 17 publications

(7 citation statements)

References 46 publications

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“…12 The success rate of transcatheter arterial embolization varies between 85% -100%. 1,6,7,10,13 Complication rates related with arterial embolization are low, ranging between 6% -9%, including post-embolization syndrome (transient fever, pelvic pain and nausea), intra-abdominal hematoma, uterine necrosis, artery dissection, lower limb ischemia, endometritis, amenorrhea and sepsis. 11,[13][14][15] We consider this case a success, as selective arterial embolization allowed hemorrhage control in an unstable patient with disseminated intravascular coagulopathy, thus minimizing the bleeding risks associated with major anesthetics and surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

“…4 Post-partum hemorrhage that occurs in the first 24 hours after delivery is considered primary and is mostly due to uterine atony, genital tract lacerations, placental retention, abnormal placentation or coagulopathy. 2,[5][6][7] We present a rare case of right uterine and cervical laceration after vacuum-assisted delivery resulting in disseminated intravascular coagulopathy, treated with uterine artery embolization and hysterectomy…”

Section: Introductionmentioning

confidence: 99%

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Uterine Artery Laceration after Vacuum Delivery

Costa¹,

Pinto²,

Morgado³

et al. 2021

Acta Med Port

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Post-partum hemorrhage is one of the leading causes of maternal mortality and it’s etiology needs to be identified in order for adequate treatment to be provided. We report a case of a post-partum hemorrhage in a multiparous woman treated with selective coil packing embolization after identification of laceration of the right uterine artery’s ascending branch. The patient was admitted to an intensive care unit in hemorrhagic hypovolemic shock and disseminated intravascular coagulation and underwent total hysterectomy due to infectious complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Uterine Artery Laceration after Vacuum Delivery

Costa¹,

Pinto²,

Morgado³

et al. 2021

Acta Med Port

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“…The aforementioned treatments are considered the optimal modalities to manage a patient with an atonic uterus and hemorrhage, who is at risk of hypovolemic shock and collapse (35). In cases of failure of these approaches, uterine artery ablation and caesarean hysterectomy are the final resorts used to prevent maternal death as a result of the severe hemorrhage (36).…”

Section: Non-obstetric Indicationsmentioning

confidence: 99%

Role of Critical Care Units in the management of obstetric patients (Review)

et al. 2021

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Pregnancy is considered a natural process for the majority of women. However, a limited proportion of pregnancies and deliveries can present with a broad variety of complications that may require admission to a Critical Care Unit (CCU). In the present review, the indications of admission of obstetrical and postpartum patients to CCUs were critically evaluated with a particular focus on the management of their complications. The management of critically ill obstetric patients remains challenging due to the physiological changes that occur during pregnancy, pregnancy-related diseases and the need to carefully consider the well-being of the fetus before any intervention can be recommended/performed. Indications for admission to CCUs include both obstetric and non-obstetric conditions that may require continuous monitoring and further interventions. Hypertensive disorders of pregnancy and mass hemorrhage are amongst the most common causes of admission to CCUs in pregnant and postpartum women. The establishment of a diagnostic and care algorithm based on the contribution of a multidisciplinary team is of critical importance to aid in the determination of which patients will require intensive care, and to assist in deciding what type of critical care each critically ill patients receives.

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“…Some studies [ 4 , 8 , 9 , 11 – 16 ] have suggested that estimated blood loss, hemoglobin concentrations, and total blood transfusion volume might be associated with the failure of UAE. The amount of blood loss during the perinatal period may be underestimated [ 19 ]. Additionally, the volumes of blood loss and blood transfused are based on the final state of the patient, and are not useful for predicting the failure of UAE.…”

Section: Case Presentationmentioning

confidence: 99%

Successful repeated uterine artery embolization in postpartum hemorrhage with disseminated intravascular coagulation: a case report and literature review

Sugai

Nonaka

Tamegai

et al. 2021

BMC Pregnancy Childbirth

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Background Postpartum hemorrhage (PPH) is a potentially fatal condition requiring urgent and appropriate intervention. Uterine artery embolization (UAE) has a high hemostatic capacity for PPH, but it may fail. Disseminated intravascular coagulation (DIC) has been reported as a risk factor associated with the failure of UAE. Case presentation A 37-year-old primigravida with dichorionic diamniotic twins and placenta previa underwent cesarean section. The blood loss during surgery was 4950 mL. Hemostasis was achieved using an intrauterine balloon tamponade device. However, she lost a further 2400 mL of blood 5 h after surgery. We embolized both uterine arteries using gelatin sponges and confirmed hemostasis. She was suffering from DIC and received ample blood transfusions. However, a further 1300 mL of blood was lost 18 h after surgery and we performed repeated UAE, with complete recanalization of the uterine arteries on both sides and re-embolization with gelatin sponges. Her DIC was treated successfully by blood transfusions at this time, and she showed no further bleeding after the repeated UAE. Conclusions DIC is a risk factor for the failure of UAE. Repeated UAE may be effective after sufficient improvement of the hematological status in patients with PPH and DIC.

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Efficacy of pelvic artery embolisation for severe postpartum hemorrhage

Cited by 17 publications

References 46 publications

Uterine Artery Laceration after Vacuum Delivery

Uterine Artery Laceration after Vacuum Delivery

Role of Critical Care Units in the management of obstetric patients (Review)

Successful repeated uterine artery embolization in postpartum hemorrhage with disseminated intravascular coagulation: a case report and literature review

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