Arterial embolization and prophylactic catheterization for the treatment for severe obstetric hemorrhage*

Ojala, Kati; PerÄlÄ, Jukka; Kariniemi, Juho; Ranta, P.; Raudaskoski, Tytti; Tekay, Aydin

doi:10.1080/j.0001-6349.2005.00727.x

Cited by 29 publications

(51 citation statements)

References 15 publications

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“…These life-threatening abnormal placental complications require aggressive blood transfusion therapy and the decision of invasive treatment must be considered within no more than 30 minutes if previous measures have failed22. With today’s imaging capabilities, knowledge of abnormal placentation can lead clinicians to prepare for delivery with interventional radiologists, uterotonics, uterine balloon compression devices, transfusion services, and the optimal surgical team available23, 24.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Peripartum Hysterectomy

Bodelón

Bernabé‐Ortiz

Schiff

et al. 2009

Obstetrics &Amp; Gynecology

181

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Objective To identify factors associated with peripartum hysterectomy performed within 30 days postpartum. Methods This was a population-based case-control study using Washington State birth certificate registry (1987-2006) linked to the Comprehensive Hospital Abstract Reporting System (CHARS). Cases underwent hysterectomy within 30 days postpartum. Controls were frequency matched 4:1. Exposures included factors related to hemorrhage, delivery method, multiple gestations, and infection. Incidence rates of peripartum hysterectomy and maternal and neonatal morbidity/mortality were assessed. Adjusted odds ratios (aOR) by maternal age, parity, gestational age, year of birth, and mode of delivery and 95% confidence intervals (CI) were computed. Results There were 896 hysterectomies. Incidence rates ranged from 0.25 in 1987to 0.82 per 1,000 deliveries in 2006 (χ2 for trend, p<0.001). Factors related to hemorrhage were strongly related to peripartum hysterectomy. Placenta previa (192 cases vs. 23 controls; aOR=7.9, 95% CI: 4.1– 15.0), abruptio placenta (71 vs. 55; aOR=3.2, 95% CI: 1.8–5.8), and retained placenta (214 vs. 28; aOR=43.0, 95% CI: 19.0–97.7) increased the risk of hysterectomy, as did uterine atony, uterine rupture, and thrombocytopenia. Having multiple gestations did not. As compared with vaginal delivery, vaginal delivery after cesarean (27 cases vs. 105 controls; aOR=1.9, 95% CI: 1.2–3.0), primary cesarean (270 vs. 504; aOR=4.6, 95% CI: 3.5–6.0), and repeat cesarean (296 vs. 231; aOR=7.9, 95% CI: 5.8-10.7) increased the risk of peripartum hysterectomy. Among the 111 women who had hysterectomy on readmission (12.8% of cases), hemorrhage- and infection-related factors were still strongly associated with peripartum hysterectomy. Conclusion Incidence rates of peripartum hysterectomy are increasing over time. The most important risk factor for peripartum hysterectomy is hemorrhage, most notably caused by uterine rupture, retained placenta, and atony of uterus.

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Section: Discussionmentioning

confidence: 99%

Factors Associated With Peripartum Hysterectomy

Bodelón

Bernabé‐Ortiz

Schiff

et al. 2009

Obstetrics &Amp; Gynecology

181

View full text Add to dashboard Cite

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“…The extirpative approach usually requires an adjuvant hemostatic technique, such as bilateral internal iliac artery ligation or preoperative placement of balloon occlusion at the upper reaches of the artery. Carnevale et al described 21 cases of IIABO used to treat patients with placenta accreta who underwent cesarean hysterectomy, and concluded that this technique is safe and effectively reduces blood loss.¹ Some reports have reached similar conclusions [2–4]. In our case, we attempted to perform IIABO; however, massive vaginal bleeding suddenly occurred due to detachment of the placenta as a result uterine contractions.…”

Section: Discussionmentioning

confidence: 53%

“…The generally accepted treatment for placenta percreta is cesarean hysterectomy without attempts to detach the placenta. Preoperative internal iliac artery balloon occlusion (IIABO) has been widely performed to reduce the blood loss during cesarean hysterectomy to treat an abnormal attachment of the placenta [1–4]. …”

Section: Introductionmentioning

confidence: 99%

Exchange of intraoperative balloon occlusion of the internal iliac artery for the common iliac artery during cesarean hysterectomy in a patient with placenta percreta

et al. 2013

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Patient: Female, 36Final Diagnosis: Pregnancy – placenta incretaSymptoms: —Medication: —Clinical Procedure: Cesarean hysterectomySpecialty: Obstetrics and GynecologyObjective:Unusual clinical courseBackground:The generally accepted treatment for placenta percreta is cesarean hysterectomy without attempts to detach the placenta. Preoperative internal iliac artery balloon occlusion (IIABO) has been widely performed to minimize blood loss during cesarean hysterectomy for an abnormal attachment of the placenta. Our case is the first reported case of common iliac artery balloon occlusion (CIABO) being more effective than IIABO for reducing blood loss during a cesarean hysterectomy in the same patient.Case Report:We performed cesarean hysterectomy with IIABO in a 36-year-old Japanese female who had placenta percreta. However, there was still a large amount of blood loss. We immediately changed the balloon from the internal iliac artery to the common iliac artery, which visibly reduced the amount of blood loss. We finally achieved cesarean hysterectomy.Conclusions:CIABO was found to be more effective than IIABO for reducing blood loss during cesarean hysterectomy. Failure of IIABO can be explained by the presence of extensive anastomoses in the pelvic vasculature.

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“…Hemostasis by interventional radiology is also considered. In obstetric patients, prophylactic arterial embolization and catheterization have been reported [29]. …”

Section: Blood Transfusionmentioning

confidence: 99%

“…Anesthesiologists, surgeons, radiologists, nurses, and clinical engineers in the operating room and staff of blood transfusion services are all essential to save a patient's life [10,11]. The survival rate after massive or critical hemorrhage might be lower in a hospital where surgeons can perform damage control surgery and radiologists can perform interventional radiology [27-29]. Even in JSA-certified training hospitals with more than 500 beds, there are insufficient ABO-identical RBCs to deal with blood loss exceeding 5,000 ml [11].…”

Section: Centralizationmentioning

confidence: 99%

Risk and crisis management in intraoperative hemorrhage: Human factors in hemorrhagic critical events

Irita

2011

Korean J Anesthesiol

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Hemorrhage is the major cause of cardiac arrest developing in the operating room. Many human factors including surgical procedures, transfusion practices, blood supply, and anesthetic management are involved in the process that leads to hemorrhage developing into a critical situation. It is desirable for hospital transfusion committees to prepare hospital regulations on 'actions to be taken to manage critical hemorrhage', and practice the implementation of these regulations by simulated drills. If intraoperative hemorrhage seems to be critical, a state of emergency should immediately be declared to the operating room staff, the blood transfusion service staff, and blood bank staff in order to organize a systematic approach to the ongoing problem and keep all responsible staff working outside the operating room informed of events developing in the operating room. To rapidly deal with critical hemorrhage, not only cooperation between anesthesiologists and surgeons but also linkage of operating rooms with blood transfusion services and a blood bank are important. When time is short, cross-matching tests are omitted, and ABO-identical red blood cells are used. When supplies of ABO-identical red blood cells are not available, ABO-compatible, non-identical red blood cells are used. Because a systematic, not individual, approach is required to prevent and manage critical hemorrhage, whether a hospital can establish a procedure to deal with it or not depends on the overall capability of critical and crisis management of the hospital.

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Arterial embolization and prophylactic catheterization for the treatment for severe obstetric hemorrhage*

Cited by 29 publications

References 15 publications

Factors Associated With Peripartum Hysterectomy

Factors Associated With Peripartum Hysterectomy

Exchange of intraoperative balloon occlusion of the internal iliac artery for the common iliac artery during cesarean hysterectomy in a patient with placenta percreta

Risk and crisis management in intraoperative hemorrhage: Human factors in hemorrhagic critical events

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