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子宫动脉栓塞术:一例原发性产后出血管理的病例报告

Uterine Artery Embolization: A Case Report on Primary Postpartum Hemorrhage Management.

作者信息

Mandviya Shruti H, Hingway Snehlata, Ghule Vishal

机构信息

Pathology and Laboratory Medicine, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Jul 6;16(7):e63956. doi: 10.7759/cureus.63956. eCollection 2024 Jul.

Abstract

When traditional therapies fail to control obstetric emergencies such as postpartum hemorrhage (PPH), uterine artery embolization (UAE) has become an essential intervention. This case study demonstrates the effective use of UAE in a 32-year-old patient who had an elective cesarean section and was experiencing refractory PPH. Despite initial attempts at controlling bleeding with uterotonic agents and surgical intervention, the hemorrhage persisted, necessitating packed red blood cell transfusion. A multidisciplinary team opted for UAE due to the patient's deteriorating condition. Gelatin sponge particles were utilized as embolic agents, resulting in the immediate cessation of uterine blood flow and the stabilization of the patient. This case underscores the importance of early detection, collaborative decision-making, and prompt intervention in managing PPH. UAE offers several advantages, including targeted vascular occlusion, rapid bleeding control, and the preservation of fertility. Further research and practice are warranted to optimize UAE techniques and enhance outcomes in obstetric emergencies. The primary cause of severe maternal morbidity and death is postpartum hemorrhage. For successful uterine artery embolization (UAE), prompt management is essential. UAE is widely acknowledged as a dependable and safe process.

摘要

当传统疗法无法控制产后出血(PPH)等产科急症时,子宫动脉栓塞术(UAE)已成为一项重要的干预措施。本病例研究展示了UAE在一名32岁择期剖宫产且出现难治性PPH患者中的有效应用。尽管最初尝试使用宫缩剂控制出血并进行了手术干预,但出血仍持续,需要输注浓缩红细胞。由于患者病情恶化,多学科团队选择了UAE。使用明胶海绵颗粒作为栓塞剂,导致子宫血流立即停止,患者病情稳定。该病例强调了在管理PPH中早期检测、共同决策和及时干预的重要性。UAE具有多种优势,包括靶向血管闭塞、快速控制出血和保留生育能力。有必要进行进一步的研究和实践,以优化UAE技术并改善产科急症的治疗效果。严重孕产妇发病和死亡的主要原因是产后出血。对于成功的子宫动脉栓塞术(UAE),及时处理至关重要。UAE被广泛认为是一个可靠且安全的过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa9b/11299369/b5040660bff5/cureus-0016-00000063956-i01.jpg

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