Uterine artery embolisation for obstetric hemorrhages treatment
Journal Title: Postępy Nauk Medycznych - Year 2015, Vol 28, Issue 2
Abstract
Introduction. The major causes of death in women of reproductive age are pregnancy and perinatal complications. According to the WHO data, postpartum haemorrhage (PPH) occurs in about 10.5% of deliveries worldwide and is the leading single cause of mortality amongs young women (estimated at about 25% of deaths). PPH is diagnosed as blood loss > 500 ml during vaginal delivery. Haemorrhages can be effectively treated avoiding surgical interventions by uterine artery embolisation (UAE).Aim. Assessment of efficacy and outcomes of percutaneous uterine artery embolisation for the treatment of postpartum haemorrhage and assessment the validity of prophylactic catheter balloons arteries leaving in the internal iliac artery.Material and methods. In the years 2011-2014, 12 uterine artery embolisation procedures were carried out in the Department of Interventional Radiology and Neuroradiology MU Lublin. The embolisation procedures were performed using gelatin foam or Embozene calibrated particles. The technical success was lack of contrast blood inflow into the uterine arteries.Results. In 5 cases embolisation were performed using standard catheters and gelatin foam; in 7 cases microcatheters and spherical, calibrated Embozene particles, 500 and 700 um in diameter, had to be used. In the 11 patients, the embolisation procedures effectively stopped bleedings. In one patient, hysterectomy was performed several hours after embolisation due to further bleeding. Clinical efficacy was found to be 91%.Conclusions. The procedure of percutaneous uterine artery embolisation seems to be an effective and safe method for the treatment of postpartum haemorrhage. The key to success is cooperation of gynaecologists and interventional radiologists and developed fast-track referral of patients. In some cases prophylactic artery catheterization balloon leaving in the internal iliac artery is also recommended.
Authors and Affiliations
Krzysztof Pyra, Anna Drelich-Zbroja, Sławomir Woźniak, Klaudia Karska, Tomasz Roman, Łukasz Światłowski, Małgorzata Szczerbo-Trojanowska
Keywords
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