CIRSE standards of practice on gynaecological and obstetric haemorrhage

Rand, Thomas; Patel, Raf; Magerle, Wolfgang; Uberoi, Raman

doi:10.1186/s42155-020-00174-7

Cited by 25 publications

(45 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The importance of IR in management of postpartum haemorrhage well recognised, and this is increasingly being used for women with abnormally invasive placentas and at high risk of major obstetric haemorrhage 8 9. But while guidelines exist for IR management of major obstetric and gynaecological haemorrhage, these guidelines presume delivery of the fetus has already occurred and do not provide guidance on optimum management strategies with the fetus in utero 10. In this case, the control of proximal inflow to the aneurysm prior to laparotomy was essential to limit the ongoing arterial bleeding as surgical splenectomy was complicated due to displacement of organs secondary to the gravid uterus.…”

Section: Discussionmentioning

confidence: 99%

Splenic artery aneurysm rupture in pregnancy: challenges in diagnosis and the importance of multidisciplinary management

et al. 2022

View full text Add to dashboard Cite

This case of acute rupture of a splenic artery aneurysm in a patient 35 weeks pregnant demonstrates the difficulties in diagnosis and importance of multidisciplinary team management for surgical emergencies in pregnancy. A women in her early 30s presented at 35 weeks pregnant with sudden onset of severe epigastric pain and shortness of breath and was found to be tachycardic with a raised lactate. Differentials included a possible vascular event or pulmonary embolism. A CT scan demonstrated free fluid and likely ruptured splenic artery aneurysm. A rapid, thorough preoperative meeting enabled us to integrate multidisciplinary care effectively. She underwent coiling of her splenic artery, which was essential to reduce further intraoperative blood loss, followed by a midline incision for caesarean section of her baby and splenectomy. She had a long stay in the intensive care unit (ITU) and complex postoperative course but was discharged after 2 months to be reunited with her baby who was in good condition.

show abstract

Section: Discussionmentioning

confidence: 99%

Splenic artery aneurysm rupture in pregnancy: challenges in diagnosis and the importance of multidisciplinary management

et al. 2022

View full text Add to dashboard Cite

show abstract

“…While uterine arteries are the most common vessels to be embolized to control bleeding, other visceral arteries which may be targeted involves ovarian, vaginal, and internal pudendal. 1 – 3 …”

Section: U Terine a Rtery E ...mentioning

confidence: 99%

“…PPH can be divided into a primary hemorrhage (>500 mL bleeding from the genital tract within the first 24 hours after birth) and secondary hemorrhage (after the first 24 hours till 6 weeks after the birth). 1 Uterine atony and trauma/laceration of the genital tract are the common causes of primary PPH. Other less frequent causes include congenital or acquired coagulation disorders, ruptured pseudoaneurysm, placental accreta spectrum (PAS), uterine rupture, inversion of uterus, fibroids, retention of placental fragments, coagulopathies, and uterine vascular malformation.…”

Section: U Terine a Rtery E ...mentioning

confidence: 99%

“…PPH is initially managed by fluid resuscitation, removal of retained placental tissue, coagulopathy correction, uterotonic drugs, and tamponade by balloon, which may stop bleeding in up to 85% of the patients. 1 , 4 With the advent of obstetric interventions, OHE/UAE is performed to arrest the blood loss. OHE/UAE is the treatment of choice in uncontrolled PPH and should be performed when initial medical therapy fails and before any surgical therapy.…”

Section: U Terine a Rtery E ...mentioning

confidence: 99%

“…There can be complications of pregnancy during the gestational period or postpartum affecting the mother, fetus, or both. 1 Interventional radiologists treat postpartum hemorrhage (PPH), abnormal placental implantation, ectopic pregnancy, thromboembolic disease, puerperal sepsis, and obstructive uropathy. Interventional radiology (IR) offers nonsurgical therapeutic options, which not only reduce morbidity and mortality, but also improve the potential to preserve fertility.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Interventional Radiology in Obstetric Emergencies

Gupta¹,

Kulkarni²,

Shetty³

et al. 2022

Indian Journal of Critical Care Medicine

View full text Add to dashboard Cite

A bstract Postpartum hemorrhage (PPH) is one of the common causes of morbidity as well as mortality among pregnant women. Obstetric hemorrhage embolization (OHE)/uterine artery embolization (UAE) is the preferred treatment for PPH which has failed medical therapy. In cases of placental accreta spectrum (PAS), balloon catheter can be prophylactically placed in internal iliac arteries (IIAs) bilaterally before delivery to enable postpartum control of bleeding. An inferior vena cava (IVC) filter can be placed under fluoroscopy for a pregnant woman with deep vein thrombosis (DVT) for whom anticoagulation is contraindicated or needs to be stopped at the time of labor. Injection of chemical into the gestational sac can be performed under ultrasonography (USG) guidance to treat ectopic pregnancy. Percutaneous or transvaginal drainage of a collection can be done by ultrasound or computed tomography (CT) guidance for puerperal sepsis. Percutaneous nephrostomy (PCN) is performed for obstructive ureterolithiasis in case of urosepsis or significant stone burden. Sonography should be used for the guidance of interventional radiology (IR) procedures whenever possible. Fluoroscopy must be used only if necessary, giving special attention to radiation-sparing maneuvers. How to cite this article Kulkarni S, Shetty NS, Gupta A, Rao S, Bansal H. Interventional Radiology in Obstetric Emergencies. Indian J Crit Care Med 2021;25(Suppl 3):S273–S278.

show abstract

The anatomy of the uterine artery: A meta‐analysis with implications for gynecological procedures

et al. 2022

View full text Add to dashboard Cite

The uterine artery (UA) is an arterial branch of the internal iliac artery in women, usually arising from the anterior division of the internal iliac artery. However, due to the high variability in the anatomy of the UA, embolization of this vessel may be challenging. Therefore, the objective of this meta‐analysis was to provide physicians with transparent data on the anatomy of the UA, using the available data in the literature. Databases such as PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched to find all the relevant studies regarding the UA. A total of 16 articles met the required criteria. The UA was found to originate most frequently from the internal iliac artery as the pooled prevalence was set to be 61.72% (95% CI: 41.31%–80.31%). A pooled prevalence of the UA originating from the umbilical artery was established at 13.93% (95% CI: 2.76%–30.44%). A pooled prevalence of the UA originating from the inferior gluteal artery was set to be 5.22% (95% CI: 0.00%–15.44%). In conclusion, we believe that this is the most accurate and up‐to‐date study regarding the highly variable anatomy of the UA. The UA originates most frequently from the internal iliac artery (61.72%), however, other origins, such as from the umbilical artery (13.93%) or the inferior gluteal artery (5.22%) may occur. It is hoped that the results of the present meta‐analysis will be a helpful tool for surgeons performing pelvic or gynecological surgeries.

show abstract

CIRSE standards of practice on gynaecological and obstetric haemorrhage

Cited by 25 publications

References 64 publications

Splenic artery aneurysm rupture in pregnancy: challenges in diagnosis and the importance of multidisciplinary management

Splenic artery aneurysm rupture in pregnancy: challenges in diagnosis and the importance of multidisciplinary management

Interventional Radiology in Obstetric Emergencies

The anatomy of the uterine artery: A meta‐analysis with implications for gynecological procedures

Contact Info

Product

Resources

About