| Arterial embolization in the treatment of intractable postpartum hemorrhage caused by soft birth canal injury |
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| Citation of this paper:ZHAO Liang, SUN Li-fang, ZHENG Xiu-li, LIU Jing-fang, ZHENG Rong, LYU Qing-qing, YU Yin-tao, ZHANG Han.Arterial embolization in the treatment of intractable postpartum hemorrhage caused by soft birth canal injury[J].Chinese Journal of Clinical Medicine,2018,25(5):757-760 |
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| Author Name | Affiliation | | ZHAO Liang, SUN Li-fang, ZHENG Xiu-li, LIU Jing-fang, ZHENG Rong, LYU Qing-qing, YU Yin-tao, ZHANG Han | Department of Obstetrics and Gynecology, Beijing Jishuitan Hospital, Beijing 100035, China |
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| Abstract:Objective：To investigate the efficacy and safety of pelvic artery embolization (PAE) in the treatment of intractable postpartum hemorrhage caused by soft birth canal injury.
Methods：Clinical data of patients with refractory postpartum hemorrhage due to soft birth canal injury and receiving PAE from January 2014 to December 2017 in Beijing Jishuitan Hospital were collected. The hemorrhage reasons and efficacyof PAE for the disease were analyzed.
Results：8 cases of refractory postpartum hemorrhage caused by soft birth canal injury accounted for 42% of refractory postpartum hemorrhage in our hospital. Of the 8 patients, 4 had vaginal delivery and 4 had cesarean delivery. 6 patients underwent vaginal wall hematoma removal before surgery. 8 patients were treated with uterine contractions before surgery. A total of 19 arteries were embolized in 8 patients, including 6 bilateral uterine arteries, 1 right pudendal artery and 2 bilateral uterine arteries, and 2 bilateral uterine arteries and 2 internal iliac artery trunks. Outcomes of the 8 patients were technically and clinically successful. 2 patients developed mild fever after surgery. All the 8 patients retained the uterus, and all of them recovered regular menstruation. Among them, 7 patients had no significant changes in the amount of menstruation, and 1 patient had decreased menstrual volume.
Conclusions：PAE is effective in the treatment of refractory postpartum hemorrhage caused by soft birth canal injury. It is safe and minimally invasive, and could be the first line treatment after conservative treatment. |
| keywords:soft birth canal injury postpartum hemorrhage arterial embolism pelvic safety |
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