Hajmurad Omar S, Choxi Ankeet A, Zahid Zahira, Dudaryk Roman
From the Department of Anesthesiology, Division of Obstetric Anesthesia, Miller School of Medicine, University of Miami, Jackson Memorial Hospital, Miami, Florida.
A A Case Rep. 2017 Aug 1;9(3):90-93. doi: 10.1213/XAA.0000000000000535.
Postpartum hemorrhage (PPH) contributes to 25% of maternal deaths worldwide. Abnormal placentation is a well-known culprit of PPH. Although controversial, iliac artery balloon occlusion has been used in patients to decrease bleeding. The use of antifibrinolytic agents, such as tranexamic acid (TXA), have gained popularity in the management of PPH. We present a 35-year-old parturient with placenta percreta that was managed with internal iliac artery balloon occlusion with concomitant use of TXA during urgent cesarean hysterectomy with subsequent aortoiliac thrombosis formation. The role of both TXA and arterial balloons in PPH, along with their respective limitations, are discussed.
产后出血（PPH）占全球孕产妇死亡的25%。胎盘植入异常是PPH的一个众所周知的病因。尽管存在争议，但髂动脉球囊封堵术已被用于患者以减少出血。抗纤溶药物，如氨甲环酸（TXA），在PPH的管理中越来越受欢迎。我们报告了一名35岁的患有穿透性胎盘植入的产妇，在紧急剖宫产子宫切除术中采用髂内动脉球囊封堵术并同时使用TXA进行治疗，随后形成了主髂动脉血栓。本文讨论了TXA和动脉球囊在PPH中的作用及其各自的局限性。
