Document Detail

Severe postpartum haemorrhage from ruptured pseudoaneurysm: successful treatment with transcatheter arterial embolization.
MedLine Citation:
PMID:  18270711     Owner:  NLM     Status:  MEDLINE    
The purpose of this retrospective study was to evaluate the role of transcatheter arterial embolization in the management of severe postpartum haemorrhage due to a ruptured pseudoaneurysm and to analyse the clinical symptoms that may suggest a pseudoaneurysm as a cause of postpartum haemorrhage. A retrospective search of our database disclosed seven women with severe postpartum haemorrhage in whom angiography revealed the presence of a uterine or vaginal artery pseudoaneurysm and who were treated using transcatheter arterial embolization. Clinical files were reviewed for possible clinical findings that could suggest pseudoaneurysm as a cause of bleeding. Angiography revealed extravasation of contrast material in five out of seven patients. Transcatheter arterial embolization allowed to control the bleeding in all patients and subsequently achieve vaginal suture in four patients with vaginal laceration. No complications related to transcatheter arterial embolization were noted. Only two patients had uterine atony, and inefficiency of sulprostone was observed in all patients. Transcatheter arterial embolization is an effective and secure technique for the treatment of severe postpartum haemorrhage due to uterine or vaginal artery pseudoaneurysm. Ineffectiveness of suprostone and absence of uterine atony should raise the possibility of a ruptured pseudoaneurysm.
Philippe Soyer; Yann Fargeaudou; Olivier Morel; Mourad Boudiaf; Olivier Le Dref; Roland Rymer
Publication Detail:
Type:  Journal Article     Date:  2008-02-13
Journal Detail:
Title:  European radiology     Volume:  18     ISSN:  0938-7994     ISO Abbreviation:  Eur Radiol     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-08     Completed Date:  2008-10-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1181-7     Citation Subset:  IM    
Department of Abdominal Imaging, Hopital Lariboisière-AP-HP Université Paris 7, 2, rue Ambroise Paré, 75475 Paris cedex 10, France.
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MeSH Terms
Aneurysm, False / complications*,  radiography
Angiography, Digital Subtraction
Embolization, Therapeutic / methods*
Extravasation of Diagnostic and Therapeutic Materials
Postpartum Hemorrhage / etiology,  radiography,  therapy*
Retrospective Studies
Treatment Outcome
Uterine Inertia
Uterus / blood supply*

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