Although it is widely accepted that uterine artery embolization (UAE) is an effective therapeutic strategy for postpartum hemorrhage (PPH), no consensus has been reached regarding the efficacy of UAE in patients with PPH with disseminated intravascular coagulation (DIC). This single-center retrospective cohort study included patients treated with UAE using NBCA for PPH between 2010 and 2015. The patients were divided into DIC and non-DIC groups, according to the obstetrical DIC score and the overt DIC diagnostic criteria issued by the International Society of Thrombosis and Haemostasis (ISTH), and their clinical outcomes were compared. There were 28 patients treated with UAE using NBCA. Complete hemostasis was achieved by UAE in 19 of 28 patients. In eight of nine patients with unsuccessful hemostasis, surgical hemostatic interventions were performed after UAE, and hemostasis was achieved in seven patients. UAE using NBCA showed no significant intergroup differences in complete hemostasis according to the presence or absence of DIC based on obstetrical DIC score (70% versus 62.5%, = 1.000) or ISTH DIC score (54.5% versus 76.5%, = 0.409). UAE using NBCA may be a useful first-choice treatment for PPH with DIC.
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http://dx.doi.org/10.1155/2017/1562432 | DOI Listing |
Biomed Res Int
March 2017
Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Japan.
Although it is widely accepted that uterine artery embolization (UAE) is an effective therapeutic strategy for postpartum hemorrhage (PPH), no consensus has been reached regarding the efficacy of UAE in patients with PPH with disseminated intravascular coagulation (DIC). This single-center retrospective cohort study included patients treated with UAE using NBCA for PPH between 2010 and 2015. The patients were divided into DIC and non-DIC groups, according to the obstetrical DIC score and the overt DIC diagnostic criteria issued by the International Society of Thrombosis and Haemostasis (ISTH), and their clinical outcomes were compared.
View Article and Find Full Text PDFJpn J Radiol
October 2013
Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8510, Japan,
Purpose: To compare the degree of uterine damage caused by uterine artery embolization (UAE) with gelatin sponge particles (GSPs) and N-butyl cyanoacrylate (NBCA) in swine.
Materials And Methods: Fifteen swine were divided into three groups of five according to embolic material: group A (1-mm GSPs), group B (NBCA:Lipiodol = 1:1), and group C (NBCA:Lipiodol = 1:7). The uterine arteries were completely occluded bilaterally.
J Vasc Interv Radiol
December 2011
Department of Radiology, Gifu University Hospital, Gifu, Japan.
The present report describes uterine artery embolization (UAE) with N-butyl cyanoacrylate (NBCA) in four patients with postpartum hemorrhage (PPH) in a coagulopathic condition. Initial UAE with gelatin sponge particles and/or fibered platinum microcoils had failed in these patients. Subsequently, a mixture of NBCA and iodinated poppy seed oil (Lipiodol) was used as embolic material, and hemostasis was achieved immediately in all patients.
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