This poster is published under an
open license. Please read the
disclaimer for further details.
Keywords:
Interventional vascular, Obstetrics (Pregnancy / birth / postnatal period), Fluoroscopy, MR, Ultrasound, Embolisation, Intraoperative, Surgery, Obstetrics
Authors:
A. Rebonato, S. Mosca, M. J. Fischer, D. Maiettini, L. Bellantonio, C. Fusco, C. D'Elia, G. A. Crinò, M. Scialpi; Perugia/IT
DOI:
10.1594/ecr2015/B-1268
Methods and materials
We collected data for this retrospective study from the clinical records of our institution.
Between 2009 and 2013,
seventy-six patients with imaging confirmed diagnosis (MRI or US) of API were managed with our protocol for API deliveries.
A 5F introducer sheath was positioned in the common femoral artery in the angiographic suite in all patients prior to the delivery [8].
Twelve of these 76 patients,
experienced an intractable intra-operative PPH after caesarean delivery and underwent pelvic artery embolization (PAE) to control a massive haemorrhage.
Usually,
patients were initially treated with uterotonic drugs and obstetric manoeuvres,
then with balloon tamponade and sutures.
If bleeding was not controlled decision hysterectomy or PAE was made even for patients that were haemodynamically unstable.
The decision on whether to proceed to PAE or not was physician related for each individual case [3].
Technical success was defined as the cessation of contrast extravasation on angiography and/or angiographically successful embolization of the uterine artery or anterior division of the internal iliac artery [9].
Clinical success was defined as the ability to stop bleeding and to control the haemorrhage without the need for repeat any surgical or embolic procedure.