From the Department of Radiology, New York University Grossman School of Medicine, New York, NY (K.M., P.N.S., N.M.H.); Department of Radiology, University of Cincinnati College of Medicine, Mason, Ohio (S.A.W.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (M.K.D.); Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (P.G.); Department of Radiology, Mount Sinai Hospital, New York, NY (A.K.); University of Pittsburgh Medical Centre, Pittsburgh, Pa (E.M.); Departments of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (L.M.S.); and Department of Radiology, NYU Langone Health, 660 1st Ave, 3rd Floor, New York, NY 10016 (N.M.H.).
Radiographics. 2024 Apr;44(4):e230164. doi: 10.1148/rg.230164.
Severe obstetric hemorrhage is a leading cause of maternal mortality and morbidity worldwide. Major hemorrhage in the antepartum period presents potential risks for both the mother and the fetus. Similarly, postpartum hemorrhage (PPH) accounts for up to a quarter of maternal deaths worldwide. Potential causes of severe antepartum hemorrhage that radiologists should be familiar with include placental abruption, placenta previa, placenta accreta spectrum disorders, and vasa previa. Common causes of PPH that the authors discuss include uterine atony, puerperal genital hematomas, uterine rupture and dehiscence, retained products of conception, and vascular anomalies. Bleeding complications unique to or most frequently encountered after cesarean delivery are also enumerated, including entities such as bladder flap hematomas, rectus sheath and subfascial hemorrhage, and infectious complications of endometritis and uterine dehiscence. RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material. See the invited commentary by Javitt and Madrazo in this issue.
严重产科出血是全球孕产妇死亡和发病的主要原因。产前大出血对母亲和胎儿都存在潜在风险。同样,产后出血(PPH)占全球孕产妇死亡的四分之一。放射科医生应该熟悉的严重产前出血的潜在原因包括胎盘早剥、前置胎盘、胎盘植入谱系疾病和血管前置。作者讨论的 PPH 的常见原因包括子宫收缩乏力、产褥期生殖器血肿、子宫破裂和裂开、妊娠产物残留以及血管异常。剖宫产术后特有的或最常发生的出血并发症也被列举出来,包括膀胱瓣血肿、腹直肌鞘和筋膜下血肿以及子宫内膜炎和子宫裂开的感染并发症等。本文的 RSNA2024 知识测试问题可在补充材料中找到。见本期 Javitt 和 Madrazo 的特邀评论。