U.O. Radiologia, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
Radiol Med. 2013 Mar;118(2):215-28. doi: 10.1007/s11547-012-0821-y. Epub 2012 May 14.
Postpartum haemorrhage (PPH) is one of the main causes of maternal mortality and occurs in 5% of total deliveries. In this study we consider the indications for and technique and results of endovascular treatment for this serious event.
Between January 2004 and December 2010, we conducted a nonrandomised prospective study on ten women with severe PPH who were treated endovascularly in an emergency setting. The procedure was considered to be clinically successful when the PPH resolved completely without the need for further surgical intervention. Laboratory values and the number of transfused blood packs were assessed for each patient.
The endovascular procedure completely stopped the bleeding in 8/10 women. After embolisation, the remaining two patients underwent a second laparotomy, which completely arrested the bleeding. No patient died as a result of PPH, and no patient with PPH who avoided hysterectomy before endovascular treatment underwent it after the procedure.
In keeping with the literature, our study indicates that endovascular therapy can significantly help reduce the rates of hysterectomy and mortality due to PPH. This treatment, when performed in the angiography room, is safe and effective and is probably relatively uncommon and underused.
产后出血（PPH）是产妇死亡的主要原因之一，占分娩总数的 5%。本研究旨在探讨针对这一严重事件的血管内治疗的适应证、技术和结果。
2004 年 1 月至 2010 年 12 月，我们对 10 例严重 PPH 患者进行了一项非随机前瞻性研究，这些患者在紧急情况下接受了血管内治疗。当 PPH 完全缓解且无需进一步手术干预时，我们认为该手术具有临床疗效。对每位患者的实验室值和输血量进行了评估。
血管内手术完全停止了 8/10 名女性的出血。栓塞后，其余 2 名患者接受了第二次剖腹手术，出血完全停止。没有患者因 PPH 死亡，也没有在血管内治疗前避免子宫切除术的 PPH 患者在该治疗后进行了子宫切除术。
与文献一致，我们的研究表明，血管内治疗可以显著降低因 PPH 导致的子宫切除术和死亡率。这种治疗方法在血管造影室进行时安全有效，可能相对少见且未得到充分应用。
