Sidhu Harpreet Kaur, Prasad Grv, Jain Vanita, Kalra Jaswinder, Gupta Vivek, Khandelwal Niranjan
Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Acta Obstet Gynecol Scand. 2010 Aug;89(8):1096-9. doi: 10.3109/00016349.2010.481015.
We studied the role of pelvic artery embolization in management of obstetric hemorrhage by retrospective analysis of 50 cases of obstetric hemorrhage in a tertiary care referral hospital where this procedure was used. Uterine and or internal iliac artery embolization was performed for the management of postpartum hemorrhage (39 cases; 78%), post abortal bleeding (6 cases; 12%) and gestational trophoblastic disease (4 cases; 8%). In one case of postpartum hemorrhage procedure could not be performed due to arterial spasm (2%). Prophylactic embolization was carried out in one case of placenta accreta. The mean age of the women was 27 years and 54% were primiparas. In six women embolization was done after hysterectomy failed to control pelvic hemorrhage. One fourth of women had coagulopathy at the time of presentation. There were five cases of pelvic hematoma and three cases of arteriovenous malformations. The success rate of the procedure was 94% and the procedure was unsuccessful for controlling bleeding in three women. There were no major procedure related complications. Thus, pelvic artery embolization is an effective alternative to surgery in controlling obstetric hemorrhage and as a fertility and life-saving procedure.
我们通过对一家三级转诊医院中50例采用该手术治疗的产科出血病例进行回顾性分析，研究了盆腔动脉栓塞在产科出血管理中的作用。对产后出血（39例；78%）、流产后出血（6例；12%）和妊娠滋养细胞疾病（4例；8%）进行子宫动脉和/或髂内动脉栓塞治疗。在1例产后出血病例中，由于动脉痉挛（2%）未能进行该手术。对1例胎盘植入病例进行了预防性栓塞。这些女性的平均年龄为27岁，54%为初产妇。6名女性在子宫切除术后未能控制盆腔出血，随后进行了栓塞治疗。四分之一的女性在就诊时患有凝血功能障碍。有5例盆腔血肿和3例动静脉畸形。该手术的成功率为94%，3名女性的出血控制未成功。没有与手术相关的重大并发症。因此，盆腔动脉栓塞是控制产科出血的一种有效的手术替代方法，也是一种保留生育功能和挽救生命的手术。
