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Transcatheter arterial embolisation for the management of obstetric haemorrhage associated with placental abnormality in 40 cases

 Sook Min Hwang  ;  Gyeong Sik Jeon  ;  Man Deuk Kim  ;  Sang Heum Kim  ;  Jong Tae Lee  ;  Min Jeong Choi 
 EUROPEAN RADIOLOGY, Vol.23(3) : 766-773, 2013 
Journal Title
Issue Date
Adult ; Embolization, Therapeutic/methods* ; Female ; Hemostatics/therapeutic use* ; Humans ; Middle Aged ; Placenta Accreta/diagnostic imaging ; Placenta Accreta/therapy* ; Postpartum Hemorrhage/diagnostic imaging ; Postpartum Hemorrhage/therapy* ; Pregnancy ; Radiography ; Treatment Outcome
Postpartum haemorrhage ; Embolisation ; Placenta abnormality ; Preservation of fertility ; Complication
OBJECTIVE: To evaluate pelvic artery embolisation (PAE) in the emergency management of intractable postpartum haemorrhage (PPH) associated with placenta accreta (PA). METHODS: Forty such patients (PAE for PPH/PA) were retrospectively reviewed. Medical records were reviewed regarding the delivery and PAE procedure. Follow-up gynaecological outcomes after PAE were obtained by telephone interviews. RESULTS: Technical success was achieved in all women (100 %). The initial clinical success rate was 82.5 % (33/40). Three patients with PA underwent hysterectomy after PAE failed to stop the bleeding within 24 h after the embolisation. The other three patients underwent re-embolisation (two patients underwent re-embolisation on the next day and one patient had undergone re-embolisation 6 h after the first embolisation), and bleeding had stopped eventually. The clinical success rate was 92.5 %. There were four cases of immediate complications, such as, pelvic pain, nausea and urticaria. There were three late minor complications, temporary menopause, but no late major complications. After the procedure, 35 patients resumed normal menstruation, including two uncomplicated pregnancies. One patient expired owing to disseminated intravascular coagulopathy and intracerebral haemorrhage, despite successful embolisation. CONCLUSION: PAE can be performed safely and effectively for patients with PPH and PA and can preserve the uterus in many patients.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
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