Department of Obstetrics & Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy.
Obstet Gynecol. 2013 Feb;121(2 Pt 2 Suppl 1):443-7. doi: 10.1097/aog.0b013e31827d90e1.
Postpartum hematomas are a potentially serious obstetric complication for which management options are not standardized. We report successful treatment of a large postpartum hematoma using arterial embolization as primary approach.
A 29-year-old woman at term gestation underwent vacuum-assisted vaginal delivery. Two hours later, marked rectal pain developed. Examination revealed a large left vaginal hematoma and no obvious bleeding sites. Computed tomography demonstrated a 10-cm supralevator hematoma and extrauterine arterial bleeding. Angiography revealed contrast extravasation from a branch of the left internal pudendal artery. Selective embolization of this branch stopped the bleeding. The patient was discharged on the third postpartum day. Eight weeks after delivery, there was no evidence of the hematoma.
Arterial embolization can be used as a first-line treatment for large postpartum hematomas.
产后血肿是一种潜在的严重产科并发症，其治疗方法尚未标准化。我们报告了一例使用动脉栓塞作为主要方法成功治疗大型产后血肿的病例。
一位 29 岁的足月妊娠妇女行真空辅助阴道分娩。两小时后，出现明显的直肠疼痛。检查发现左侧阴道大血肿，无明显出血部位。计算机断层扫描显示 10cm 高的阴道上血肿和子宫外动脉出血。血管造影显示左侧阴部内动脉分支有造影剂外渗。对该分支进行选择性栓塞止血。患者于产后第 3 天出院。产后 8 周时，血肿无明显痕迹。
动脉栓塞可作为治疗大型产后血肿的一线治疗方法。
