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Emergency peripartum hysterectomy arterial embolization

Nabil Mathlouthi, Haikel Trabelsi, Sonia Zayen, Habib Amouri, Mohamed Dhouib, Kaies Chaabene, Mohamed Ayadi, Kamel Kolsi, Belhassen Ben Ayed, Mohamed Guermazi
AIM: Detect the risk factors, indications and maternal morbidity of haemostatic hysterectomy. METHODS: A retrospective study of 46 women who had haemostatic hysterectomy between 2005 and 2009. RESULTS: The mean age was 33.3 years. The mean parity was 3.5. 35% of patients had a previous cesarean section. The mode of delivery was: vaginal delivery (47.8%), cesarean delivery (52.2 %). The hysterectomy was subtotal in 39 cases (85%). The indications of haemostatic hysterectomy was: uterine inertia (44%), disseminated intravascular coagulation (26%), placenta accreta (8...
August 2012: La Tunisie Médicale
Giovanni Zanconato, Elena Cavaliere, Carlotta Iacovella, Aurora Vassanelli, Vittorio Schweiger, Sonia Cipriani, Massimo Franchi
OBJECTIVE: To assess prevalence and causes of severe acute maternal morbidity cases and evaluate their impact on feto-maternal wellbeing and on facility resources. STUDY DESIGN: Observational retrospective study adopting management-based criteria in a tertiary care public hospital during a 5-year period. Criteria adopted were: intensive care unit admission, blood transfusion ≥ 4 units, emergency peripartum hysterectomy and arterial embolization at any time during pregnancy...
July 2012: Journal of Maternal-fetal & Neonatal Medicine
Etienne Gayat, Matthieu Resche-Rigon, Olivier Morel, Matthias Rossignol, Jean Mantz, Armelle Nicolas-Robin, Nathalie Nathan-Denizot, Jean-Yves Lefrant, Frédéric J Mercier, Emmanuel Samain, Yann Fargeaudou, Emmanuel Barranger, Marie-Josèphe Laisné, Pierre-Henri Bréchat, Dominique Luton, Ingrid Ouanounou, Patricia Appa Plaza, Claire Broche, Didier Payen, Alexandre Mebazaa
PURPOSE: Severe postpartum haemorrhage (SPPH) is the leading cause of peripartum hysterectomy and maternal death. There are no easily measurable parameters that indicate the failure of medical therapy and the need for an advanced interventional procedure (AIP) to stop genital tract bleeding. The aim of the study was to define factors predictive of the need for an AIP in the management of emergent PPH. METHODS: The study included two phases: (1) an initial retrospective study of 257 consecutive patients with SPPH, allowing the determination of independent predictors of AIP, which were subsequently grouped in a predictive score, followed by (2) a multicentre study of 239 patients admitted during 2007, designed to validate the score...
November 2011: Intensive Care Medicine
Linda A Hunter
Postpartum hemorrhage is a potentially life-threatening obstetric emergency that requires prompt nursing and medical interventions. In the majority of cases, initial strategies such as fundal massage and uterotonic medications will effectively stop excessive bleeding. Unfortunately, the incidence and severity of postpartum hemorrhage are on the rise and peripartum hysterectomy remains a life-saving intervention in cases of intractable bleeding. As an emerging alternative to hysterectomy, uterine artery embolization (UAE) has demonstrated success rates of more than 90% in controlling postpartum hemorrhage unresponsive to other therapies...
July 2010: Journal of Perinatal & Neonatal Nursing
F Sergent, B Resch, E Verspyck, B Rachet, E Clavier, L Marpeau
OBJECTIVE: Update of knowledge on the various methods of management of intractable postpartum haemorrhage. METHOD: PubMed, MEDLINE were the electronic sources, in English and French languages, used for data retrieval. Uterine atony and abnormal placental insertions (placenta praevia or accreta) are the major causes of primary postpartum haemorrhages. To preserve fertility, we dispose of angiographic selective embolization or surgical vascular ligations. Embolization is a non-invasive method practicable by simple catheterization under local anesthesia...
April 2004: Gynécologie, Obstétrique & Fertilité
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