Department of Anesthesiology, Leuven University Hospital, Leuven, Belgium.
Curr Opin Anaesthesiol. 2020 Aug;33(4):566-570. doi: 10.1097/ACO.0000000000000884.
To discuss the recent results of the use of interventional radiology modalities treating postpartum hemorrhage (PPH).
PPH still is a leading cause of maternal morbidity and mortality. An important risk factor for the development of PPH is the placenta accreta spectrum. In patients with placenta accreta, we can use prophylactic balloon occlusion of the common or internal iliac artery or abdominal aorta to prevent PPH. Balloon occlusion of the abdominal aorta seems to ensure better results than balloon occlusion of the iliac artery in terms of blood loss, transfusion rate and hysterectomy rate reduction with a minimal risk of complications. To treat PPH uterine artery embolization can be effective and potentially fertility-sparing, while having a low complication rate.
The use of aortic balloon occlusion catheters for the prevention of PPH and uterine artery embolization for the treatment of PPH are well tolerated and feasible options for patients with placenta accreta spectrum.
探讨介入放射学方法治疗产后出血（PPH）的最新结果。
PPH 仍然是产妇发病率和死亡率的主要原因。PPH 发展的一个重要危险因素是胎盘植入谱系。对于胎盘植入的患者，我们可以使用预防性球囊阻断子宫动脉或髂内动脉或腹主动脉来预防 PPH。腹主动脉球囊阻断术在减少出血量、输血率和子宫切除率方面似乎比髂动脉球囊阻断术效果更好，且并发症风险最小。对于 PPH 的治疗，子宫动脉栓塞术可以有效且有保留生育能力的潜力，同时具有较低的并发症发生率。
使用主动脉球囊阻断导管预防 PPH 和子宫动脉栓塞治疗 PPH 是胎盘植入谱系患者耐受良好且可行的选择。
