Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan and Chang Gung University College of Medicine, Taoyuan, Taiwan.
J Int Med Res. 2023 Jan;51(1):3000605221150137. doi: 10.1177/03000605221150137.
Failure of conservative management for controlling postpartum hemorrhage (PPH) is not uncommon, particularly when PPH is caused by vascular lesions. Awareness of this possibility and initiating timely trans-arterial embolization (TAE) are essential for improving the outcome. Herein, we describe the case of a 34-year-old woman presenting with arterial aneurysms with arteriovenous fistulas in the lower vagina bilaterally, which caused intractable PPH. Conservative management failed to resolve the PPH; however, TAE successfully controlled the bleeding, and the patient recovered smoothly. Knowledge of this possible etiology for intractable PPH is crucial for timely TAE. This case report aims to highlight the pivotal role of TAE in detecting and treating this unusual cause of PPH.
产后出血（PPH）的保守治疗失败并不少见，尤其是当 PPH 是由血管病变引起时。了解这种可能性并及时进行经动脉栓塞（TAE）对于改善预后至关重要。本文描述了一位 34 岁女性的病例，她双侧阴道下段存在动静脉瘘的动脉动脉瘤，导致难治性 PPH。保守治疗未能解决 PPH；然而，TAE 成功地控制了出血，患者恢复顺利。了解这种难治性 PPH 可能的病因对于及时进行 TAE 至关重要。本病例报告旨在强调 TAE 在检测和治疗这种不常见的 PPH 病因中的关键作用。
