Document Detail


Angiography as treatment for a high cervical tear. A case report.
MedLine Citation:
PMID:  12746994     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: High cervical tears are a rare but serious complication of second-trimester induced abortion. Angiographic embolization can successfully treat selected cases. This is the first case of serious hemorrhage successfully treated by angiography alone, without mechanical occlusion, after failed surgical repair. CASE: A 22-year-old primigravida sustained a high cervical tear during dilation and evacuation (D&E) abortion at 21 weeks' gestation. After stabilization with 4 units of packed red cells and vaginal packing, attempted surgical repair failed. The following day, angiography alone pinpointed and stanched the small arteriolar branch of the uterine artery responsible for the bleeding. CONCLUSION: Injury to a tiny arteriolar branch of the uterine artery during D&E abortion may be impossible to palpate or visualize, and hemostatic sutures placed extrinsically on the cervical mucosa may not be therapeutic. On occasion, injection of contrast material, without mechanical occlusive devices, may be corrective.
Authors:
E Steve Lichtenberg
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  48     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-05-15     Completed Date:  2003-08-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  287-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Northwestern University Medical Center, Albany Medical-Surgical Center, Chicago, Illinois, USA. fpamg@cais.com
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MeSH Terms
Descriptor/Qualifier:
Abortion, Therapeutic / adverse effects*,  methods
Adult
Angiography / methods
Cervix Uteri / injuries*
Dilatation and Curettage / adverse effects*,  methods
Embolization, Therapeutic / methods*
Female
Follow-Up Studies
Humans
Lacerations / radiography,  therapy*
Pregnancy
Pregnancy Trimester, Second
Risk Assessment
Treatment Outcome
Uterine Hemorrhage / radiography,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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