Transcatheter arterial embolization as first-line rescue in intractable primary postpartum hemorrhage: Assessment, outcome, and subsequent fertility

Cheng, Hsin‐Hsin; Tsang, Leo Leung-Chit; Hsu, Te‐Yao; Kung, Chia-Te; Ou, Chia-Yu; Chang, Chingching; Tsai, Ching‐Chou; Cheng, Yu‐Fan; Kung, Fu‐Tsai

doi:10.1016/j.jfma.2016.06.011

Cited by 20 publications

(22 citation statements)

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“…Related studies mostly support preservation of menstrual function and fertility following uterine embolization with gel foam, with one study reporting resumption of menses in all of their patients. Another study reported 98% preservation of menses and 82% successful future pregnancies (Touhami et al, 2014;Farouk et al, 2016;Cheng et al, 2017). Despite literature supporting preservation of fertility, gel foam poses some inherent disadvantages as an embolic agent for uterine AVM embolization compared to newer agents.…”

Section: Discussionmentioning

confidence: 99%

Precipitating hydrophobic injectable liquid (PHIL) embolic for the treatment of a uterine arteriovenous malformation: a technical report

et al. 2019

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Objective: Uterine arteriovenous malformations (AVM) are unusual causes of vaginal bleeding. Although hysterectomy is the definitive treatment; uterine artery embolization (UAE) provides an alternative therapeutic option. This case presents a technical report of a uterine AVM treated successfully with transcatheter UAE using precipitating hydrophobic injectable liquid (PHIL) embolic agent. Case report: A 41-year-old female, gravida 6, para 4, miscarriage 2, including a molar pregnancy 15 years prior, presented with massive per vaginal bleeding. Pelvic ultrasound demonstrated an acquired AVM as the underlying aetiology for her presentation. The patient underwent bilateral uterine arterial embolization. Four weeks later, there was nearly complete resolution of the AVM and the patient's menstrual cycle was restored 8 weeks after the procedure. Conclusion: Uterine AVM can be treated safely and effectively with UAE using PHIL.

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Section: Discussionmentioning

confidence: 99%

Precipitating hydrophobic injectable liquid (PHIL) embolic for the treatment of a uterine arteriovenous malformation: a technical report

et al. 2019

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“…For genital bleeding following vaginal or caesarean delivery, or due to surgical complications including post hysterectomy (Cheng et al 2017 ; Lee et al 2012a ; Fu et al 2018 ), OHE should be considered, particularly if bleeding is due to spontaneous pseudoaneurysm rupture (Fig. 5 ) (Gonsalves and Belli 2010 ).…”

Section: Treatmentmentioning

confidence: 99%

“…Permanent liquid embolic agents such as Cyanoacrylate or Onyx might be useful when a catheter cannot be passed to a sufficient distal location. However, time of polymerisation and liquid must be adjusted correctly and appropriate experience is needed (Cheng et al 2017 ; Lee et al 2012a ; Fu et al 2018 ).…”

Section: Treatmentmentioning

confidence: 99%

CIRSE standards of practice on gynaecological and obstetric haemorrhage

et al. 2020

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This CIRSE Standards of Practice document provides best practices for obstetric haemorrhage embolisation (OHE) in the management of postpartum haemorrhage (PPH). The document is aimed at interventional radiologists involved in treating postpartum haemorrhage, and has been developed by a writing group established by the CIRSE Standards of Practice Committee.CIRSE Standards of Practice documents are not clinical practice guidelines and do not intend to impose a standard of care, rather provide reasonable approaches to and best practices for specific interventional radiology treatments and techniques.

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“…Embolization makes it possible to avoid hysterectomy, while theoretically preserving the possibility of another pregnancy (5) . Cheng et al (31) described how menstruation and fertility could be preserved successfully for future pregnancy after embolization. Uterine artery embolization illustrates an important role in uterine fibroid and leiomyoma management.…”

Section: Clinical Anatomy Of Uterine Arterymentioning

confidence: 99%

Anatomic variations of the Uterine Artery. Review of the literature and their clinical significance

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et al. 2020

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Uterin arterleri uterusa kan sağlayan ana damarlardır. Esas olarak, internal iliak arterin ön gövdesinden kaynaklanırlar. Uterin arterler hamilelikte postpartum kanama ve uterin fibroid yönetimi için transkateter arteriyel embolizasyon kadar önemli bir rol oynar. Bu, anatomik çeşitliliğin PubMed'in uterus arterlerinin kökeni ve klinik önemi üzerine veritabanında yapılan bir İngiliz literatürü derlemesidir. On bir çalışma uterus arterlerinin kökenini ve literatürdeki varyasyonlarını tanımlamaktadır. Altı çalışmada, uterus arteri olguların çoğunda, ayrı bir dal olarak veya alt gluteal arter ile bifürkasyon veya superior ve inferior gluteal arter ile trifurkasyon olarak internal iliak arterden çıkmaktaydı. İki çalışmada, inferior gluteal arter uterus arterinin ana kaynağı olarak ortaya çıkarken, üç çalışmada umbilikal arteri ana kaynağı olarak ortaya çıkmıştır. Internal iliak arter, uterus arterinin en yaygın vasküler orijini olarak tanımlanır. Bununla birlikte, bu derleme uterus arterleri için ana orijin damarlarının internal iliak, umbilikal ve inferior gluteal arter olduğunu vurgulamaktadır. Bununla birlikte, bu olağandışı anatomik yapı için sınıflandırma ve daha ileri araştırmalar gelecekte esastır.

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Transcatheter arterial embolization as first-line rescue in intractable primary postpartum hemorrhage: Assessment, outcome, and subsequent fertility

Abstract: TAE was safe and effective in treating intractable primary PPH with a high success rate and preservation of menstruation and fertility.

Cited by 20 publications

References 21 publications

Precipitating hydrophobic injectable liquid (PHIL) embolic for the treatment of a uterine arteriovenous malformation: a technical report

Precipitating hydrophobic injectable liquid (PHIL) embolic for the treatment of a uterine arteriovenous malformation: a technical report

CIRSE standards of practice on gynaecological and obstetric haemorrhage

Anatomic variations of the Uterine Artery. Review of the literature and their clinical significance

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