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Zou Y, Zeng S, Huang C, Liu L, Li L. The value of fibrinogen combined with D-dimer and neonatal weight in predicting postpartum hemorrhage in vaginal delivery. J Perinat Med 2024; 52:478-484. [PMID: 38414334 DOI: 10.1515/jpm-2023-0351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/03/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVES The purpose of this study was to explore whether fibrinogen (Fib) can be used as a predictor of postpartum hemorrhage (PPH) in parturients with vaginal delivery, and the value of combining Fib with other indexes to predict postpartum hemorrhage in vaginal delivery. METHODS A total of 207 parturients who delivered via vagina were divided into PPH group (n=102) and non-PPH group (n=105). The PPH group was further divided into mild PPH group and severe PPH group. The differences of Fib, platelet (PLT), mean platelet volume (MPV), platelet distribution width (PDW), D-dimer (D-D), hemoglobin (HGB) and neonatal weight (Nw) between the two groups were compared to explore the significance of these indexes in predicting PPH. RESULTS Fib, PLT and PDW in PPH group were significantly lower than those in non-PPH group, while D-D and Nw in PPH group were significantly higher than those in non-PPH group. In the binary logistic regression model, we found that Fib, D-D and Nw were independently related to PPH. The risk of PPH increased by 9.87 times for every 1 g/L decrease in Fib. The cut-off value of Fib is 4.395 (sensitivity 0.705, specificity 0.922). The AUC value of PPH predicted by Fib combined with D-D and Nw was significantly higher than that of PPH predicted by Fib (p<0.05, 95 % CI 0.00313-0.0587). CONCLUSIONS Fib, D-D and Nw have good predictive value for PPH of vaginal delivery, among which Fib is the best. The combination of three indexes of Fib, D-D and Nw can predict PPH more systematically and comprehensively, and provide a basis for clinical prevention and treatment of PPH.
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Affiliation(s)
- Yanke Zou
- Department of Cardiology, Army Medical Center of PLA, Chongqing, P.R. China
| | - Shuai Zeng
- Department of Laboratory Pathology, Unit 32280 of the People's Liberation Army, Leshan City, Sichuan Province, P.R. China
| | - Changxiao Huang
- Department of Obstetrics and Gynecology, Army Medical Center of PLA, Chongqing, P.R. China
| | - Ling Liu
- Department of Health Statistics, Army Military Medical University, Chongqing, P.R. China
| | - Li Li
- Department of Obstetrics and Gynecology, Army Medical Center of PLA, Chongqing, P.R. China
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Wu X, Zhang M, Sun P, Jiang JJ, Yan L. Pregnancy and Adverse Obstetric Outcomes After Hysteroscopic Resection: A Systematic Review and Meta-Analysis. Front Surg 2022; 9:889696. [PMID: 35832500 PMCID: PMC9271824 DOI: 10.3389/fsurg.2022.889696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveAlthough the randomized controlled trial (RCT) of the efficacy of hysteroscopic resection in women with uterine septum has not shown any significant correlation in recent research, motivation for deeper study remains insufficient. In this study, the objective was to determine pregnancy-related outcomes, along with adverse obstetric outcomes, following hysteroscopic resection and also to determine whether women with hysteroscopic resection bear the same outcomes as women with normal uterine cavities.Search MethodsFrom January 1995 to February 2022, a systematic literature review was conducted to identify all studies published concerning the gestation outcomes of women with and without hysteroscopic resection while comparing the gestation outcomes of women after hysteroscopic resection and with a normal uterine cavity. Our primary outcome was the live birth rate (LBR). The secondary outcomes were term delivery, preterm delivery, spontaneous miscarriage, malpresentation, cesarean section, and other adverse obstetric outcomes.Results22 studies were included in this meta-analysis. The control groups of 14 studies were treated women, and the control groups of the other 8 studies were patients bearing a normal uterine cavity. Hysteroscopic resection was related to a higher rate of term delivery (OR = 2.26, 95% CI, 1.26–4.05), and a lower rate of spontaneous abortion (OR = 0.50, 95% CI, 0.27–0.93), and a lower rate of malpresentation (OR = 0.31, 95% CI, 0.19–0.50). Nevertheless, in comparison with the normal uterus group, the rates of preterm birth, cesarean section, and postpartum hemorrhage after resection did not return to normal levels.ConclusionHysteroscopic resection can effectively reduce the risk of abortion and malpresentation in patients possessing a uterine septum while increasing the term delivery rate. Although well-designed RCTs should confirm our meta-analysis, it still bears recommending to patients
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Affiliation(s)
- Xue Wu
- School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Mei Zhang
- Qufu Maternity and Infant health Hospital, Qufu, China
| | - Ping Sun
- School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jing-jing Jiang
- School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
- Key laboratory of Reproductive Endocrinology, Ministry of Education, Shandong University, Jinan, China
- Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, China
- Correspondence: Lei Yan Jing-jing Jiang
| | - Lei Yan
- School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
- Key laboratory of Reproductive Endocrinology, Ministry of Education, Shandong University, Jinan, China
- Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, China
- Correspondence: Lei Yan Jing-jing Jiang
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Prognostic capacity of inferior vena cava diameter for severe postpartum hemorrhage. Eur J Obstet Gynecol Reprod Biol 2021; 267:6-10. [PMID: 34688184 DOI: 10.1016/j.ejogrb.2021.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/02/2021] [Accepted: 10/11/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This study sought to evaluate whether or not the sonographic measurement of the inferior vena cava (IVC) diameter predicts severe bleeding in women with postpartum hemorrhage (PPH). It further compared the efficacy of the IVC diameter, shock index, and serum lactate levels in this prediction. METHODS This prospective study included female patients with ≥500 mL of bleeding after vaginal delivery between September 1, 2019 and May 31, 2021. The IVC diameter during inspiration (IVCmin) and expiration (IVCmax), shock index and serum lactate levels of the patients were measured. The patients were divided into two groups according to the postpartum vaginal blood loss [non-severe PPH and severe PPH (SPPH)]. After multivariate logistic regression analysis revealed the significant parameters, we constructed the receiver operating characteristic (ROC) curves to determine their power in predicting SPPH. RESULTS Of the 201 patients included in the study, SPPH developed in 21.4% of the population, while non-severe PPH occurred in 78.6%. The area under the curve (AUC) values of shock index, lactate, IVCmin and IVCmax for SPPH prediction were 0.772, 0.791, 0.851 and 0.874, respectively. According to the ROC analysis, at the cut-off value of 7.3 mm, IVCmax had 90.7% sensitivity and 70.8% specificity in predicting SPPH. IVCmax was independently associated with SPPH (Odds ratio: 0.74, 95% CI: 0.63-0.86). CONCLUSION We found that the ultrasonographic measurement of IVC diameter is more valuable than the shock index and lactate parameters in the early detection of SPPH. Therefore, IVC diameter may be a useful prognostic marker for SPPH.
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Almutairi WM. Literature Review: Physiological Management for Preventing Postpartum Hemorrhage. Healthcare (Basel) 2021; 9:658. [PMID: 34073073 PMCID: PMC8227540 DOI: 10.3390/healthcare9060658] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/26/2021] [Indexed: 11/17/2022] Open
Abstract
The aim of this paper was to summarize the existing literature regarding postpartum hemorrhage (PPH) and its physiological management (i.e., skin-to-skin contact and breastfeeding). The background surrounding PPH and the role of skin-to-skin contact (SSC) and breastfeeding (BF) in PPH are identified, and these interventions are supported as a crucial means of preventing or minimizing the incidence of PPH. Despite its importance, to the best of my knowledge, an evaluation of this relationship has not yet been undertaken. The narrative literature review approach was used to summarize topic related researches. The search included three databases: CINAHL, PubMed, and Google Scholar. All articles related to the role of SSC and BF in PPH were chosen from the different databases. The findings demonstrate that SSC and BF are cost-effective methods that could be considered practices for the prevention of PPH. Immediate Skin-to-skin contact (SSC) and breastfeeding (BF) are central mediators of the psychophysiological process during the first hour after delivery (the third and fourth stages of labor).
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Affiliation(s)
- Wedad M Almutairi
- Maternity and Child Department, Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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Kumar VDA, Sharmila S, Kumar A, Bashir AK, Rashid M, Gupta SK, Alnumay WS. A novel solution for finding postpartum haemorrhage using fuzzy neural techniques. Neural Comput Appl 2021. [DOI: 10.1007/s00521-020-05683-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Majluf‐Cruz K, Anguiano‐Robledo L, Calzada‐Mendoza CC, Hernández‐Juárez J, Moreno‐Hernández M, Domínguez‐Reyes VM, Figueroa‐Torres AG, Gomez‐Rosas P, Arreola‐Diaz R, García‐Lee MT, Ricardo‐Moreno MT, Sosa‐Camas RE, Garcia‐Chavez J, Vela Ojeda J, Isordia‐Salas I, Majluf‐Cruz A. von Willebrand Disease and other hereditary haemostatic factor deficiencies in women with a history of postpartum haemorrhage. Haemophilia 2019; 26:97-105. [DOI: 10.1111/hae.13900] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/18/2019] [Accepted: 11/19/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Karim Majluf‐Cruz
- Hemostasia y Aterogénesis Unidad de Investigación Médica en Trombosis IMSS Ciudad de Mexico Mexico
- Laboratorio de Farmacologia Molecular Escuela Superior de Medicina Instituto Politecnico Nacional Ciudad de Mexico Mexico
| | - Liliana Anguiano‐Robledo
- Laboratorio de Farmacologia Molecular Escuela Superior de Medicina Instituto Politecnico Nacional Ciudad de Mexico Mexico
| | - Claudia C. Calzada‐Mendoza
- Seccion de Estudios de Postgrado e Investigación Escuela Superior de Medicina Instituto Politecnico Nacional Ciudad de Mexico Mexico
| | - Jesús Hernández‐Juárez
- Hemostasia y Aterogénesis Unidad de Investigación Médica en Trombosis IMSS Ciudad de Mexico Mexico
- CONACYT‐Facultad de Odontología Universidad Autónoma Benito Juárez de Oaxaca Ciudad Universitaria Oaxaca de Juarez Oaxaca México
| | - Manuel Moreno‐Hernández
- Hemostasia y Aterogénesis Unidad de Investigación Médica en Trombosis IMSS Ciudad de Mexico Mexico
| | | | | | - Patricia Gomez‐Rosas
- Servicio de Hematologia Hospital General Regional Tecamac IMSS Estado de Mexico Mexico
| | - Rodrigo Arreola‐Diaz
- Hemostasia y Aterogénesis Unidad de Investigación Médica en Trombosis IMSS Ciudad de Mexico Mexico
| | - María Teresa García‐Lee
- Servicio de Hematologia Hospital General Regional Carlos McGregor Sanchez Navarro IMSS Ciudad de Mexico Mexico
| | | | - Rosa Elena Sosa‐Camas
- Departamento de Medicina Interna Hospital General de Hermosillo Secretaria de Salud Hermosillo Mexico
| | - Jaime Garcia‐Chavez
- Unidad de Investigación en Enfermedades Hematologicas Hospital de Especialidades CMN La Raza IMSS Ciudad de Mexico Mexico
| | - Jorge Vela Ojeda
- Unidad de Investigación en Enfermedades Hematologicas Hospital de Especialidades CMN La Raza IMSS Ciudad de Mexico Mexico
| | - Irma Isordia‐Salas
- Hemostasia y Aterogénesis Unidad de Investigación Médica en Trombosis IMSS Ciudad de Mexico Mexico
| | - Abraham Majluf‐Cruz
- Hemostasia y Aterogénesis Unidad de Investigación Médica en Trombosis IMSS Ciudad de Mexico Mexico
- Servicio de Hematologia Hospital General Regional Carlos McGregor Sanchez Navarro IMSS Ciudad de Mexico Mexico
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Mollazadeh-Moghaddam K, Dundek M, Bellare A, Borovac-Pinheiro A, Won A, Burke TF. Mechanical Properties of the Every Second Matters for Mothers-Uterine Balloon Tamponade (ESM-UBT) Device: In Vitro Tests. AJP Rep 2019; 9:e376-e383. [PMID: 31815053 PMCID: PMC6894953 DOI: 10.1055/s-0039-1697653] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/16/2019] [Indexed: 12/14/2022] Open
Abstract
Objective Postpartum hemorrhage (PPH) is the most common cause of maternal mortality and morbidity worldwide, most of which occurs in resource-poor settings. Placement of a uterine balloon may be life-saving in uncontrolled PPH. The Every Second Matters for Mothers-Uterine Balloon Tamponade (ESM-UBT) device is an ultra-low-cost uterine balloon designed for global access. The purpose of this study was to evaluate the mechanical properties of the ESM-UBT device. Study design Intraluminal pressures, diameters, and burst volumes of condom uterine balloons and Foley catheter balloons of ESM-UBT devices were measured in open air and inside uterus models. Condom uterine balloons were tested with uterus model sizes of 100, 250, and 500mL. The condom-catheter O-ring attachment tensile strength was also evaluated. Results All 28 samples of ESM-UBT condom uterine balloons maintained their integrity for at least 3 hours when subjected to pressures of 200 mm Hg or greater across each of the tested uterine volumes. No Foley catheter balloons burst after instillation of 30mL, O-rings withstood forces of 15.4 ± 2.1 N, and condom uterine balloons stretched to 35.8 ± 2.1 cm without loss of integrity. Conclusion The mechanical properties of the ESM-UBT device make it attractive for scale across resource-poor settings.
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Affiliation(s)
- Kamyar Mollazadeh-Moghaddam
- Division of Global Health Innovation, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Michelle Dundek
- Division of Global Health Innovation, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Anuj Bellare
- Division of Global Health Innovation, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Anderson Borovac-Pinheiro
- Division of Global Health Innovation, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - Alice Won
- Division of Global Health Innovation, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Thomas F Burke
- Division of Global Health Innovation, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts.,Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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Abstract
Postpartum hemorrhage (PPH) is a serious complication of giving birth that can result in death. Interventional radiology allows for the use of uterine artery embolization and transcatheter arterial embolization to prevent and treat PPH. These procedures are minimally invasive options that use the uterine or internal iliac arteries to place either a balloon or embolic material to stop the bleeding. These techniques also can be used as a preventive treatment for women with known placental abnormalities who are at an increased risk of hemorrhaging. This article discusses causes, early recognition, and treatment of PPH. It also discusses nursing care for patients with PPH and presents a case report describing the use of interventional radiology before cesarean delivery for a patient with placenta accreta.
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Newsome J, Martin JG, Bercu Z, Shah J, Shekhani H, Peters G. Postpartum Hemorrhage. Tech Vasc Interv Radiol 2017; 20:266-273. [DOI: 10.1053/j.tvir.2017.10.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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10
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Uterine Tamponade Device to Control Atonic Primary Postpartum Haemorrhage in Resource-Poor Settings. JOURNAL OF BIOMIMETICS BIOMATERIALS AND BIOMEDICAL ENGINEERING 2017. [DOI: 10.4028/www.scientific.net/jbbbe.34.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This paper proposes and presents the proof of concept for an improvised device adapted from the condom tamponade used for controlling atonic primary postpartum haemorrhage in resource-poor settings. The device has been designed to address the setbacks of the conventional condom tamponade. The setbacks of the condom tamponade were assessed. Using the systematic engineering design process, a device was designed to address the setbacks of the condom tamponade. The device comprises an inflation/deflation system, blood drainage system and clamping system. Results from testing show that for an inexperienced user, the device has quicker inflation (3.36 ± 1.70 minutes/ 500 ml) and faster set-up time (3.60 ± 1.50 minutes), as compared to the conventional condom tamponade. The clamping system of the device also ensures effective control of fluid dynamics and prevents backflow. The device, however, was not tested on human subjects to prove its efficacy for actual treatment of patients. The device also can be easily and quickly set-up and operated by frontline healthcare providers with limited expertise, in resource-poor settings. It has further been designed for safety (use of biocompatible materials and elimination of sharp edges for the parts expected to have direct contact with the uterus).
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Dhansura T, Shaikh N. The parturient in the interventional radiology suite: New frontier in obstetric anaesthesia. Indian J Anaesth 2017; 61:289-294. [PMID: 28515515 PMCID: PMC5416717 DOI: 10.4103/ija.ija_438_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The anaesthesiologist's presence during interventional radiology (IR) is increasing due to increasingly ill patients and intricate procedures. The management of a parturient in IR suite is complex in terms of logistics of an unfamiliar procedure in an unfamiliar area. The literature available is largely written by radiologists with little attention paid to anaesthetic details and considerations. In the Indian scenario, in the absence of hybrid operating rooms (ORs), logistics involve transport of a parturient back and forth between the IR suite and the OR. As members of a multidisciplinary team, anaesthesiologists should utilise their expertise in fluid management, transfusion therapy and critical care to prevent and treat catastrophic events that may accompany severe peri-partum bleeding. Ensuring familiarity with the variety of IR procedures and the peri-procedure requirements can help the anaesthesiologist provide optimum care in the IR suite.
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Affiliation(s)
- Tasneem Dhansura
- Department of Anaesthesiology, Saifee Hospital, Mumbai, Maharashtra, India
| | - Nabila Shaikh
- Department of Anaesthesiology, Saifee Hospital, Mumbai, Maharashtra, India
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Kelly W, Massoumi A, Lazarus A. Asthma in pregnancy: Physiology, diagnosis, and management. Postgrad Med 2015; 127:349-58. [PMID: 25702799 DOI: 10.1080/00325481.2015.1016386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Asthma is a common, potentially serious, medical condition that affects an estimated 8% of pregnant patients, with 4% of all pregnant patients experiencing an exacerbation in the past year. Practitioners must be able to diagnose, educate, and treat such patients as they undergo significant physiological and immunologic change. But staying current can be challenging given over 3000 citations for "asthma and pregnancy" in a recent PubMed search, with 750 described as review articles. Patients have even more difficulty navigating information, with 29 million Google search results for this same query and 1.2 million alone for the question whether asthma medications are safe during pregnancy. This review provides brief answers to important management questions followed by supporting background literature.
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de Souza MDL, Laurenti R, Knobel R, Monticelli M, Brüggemann OM, Drake E. Maternal mortality due to hemorrhage in Brazil. Rev Lat Am Enfermagem 2014; 21:711-8. [PMID: 23918016 DOI: 10.1590/s0104-11692013000300009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 02/14/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to analyze the rates of maternal mortality due to hemorrhage identified in Brazil from 1997 to 2009. METHODS the time series and population data from the Brazilian Health Ministry, Mortality Information System and Live Birth Information System were examined. From the Mortality Information System, we initially selected all reported deaths of women between 10 and 49 years old, which occurred from January 1, 1997 to December 31, 2009 in Brazil, recorded as a "maternal death". RESULTS during the research period, 22,281 maternal deaths were identified, among which 3,179 were due to hemorrhage, accounting for 14.26% of the total deaths. The highest rates of maternal mortality were found in the North and Northeast areas of Brazil. CONCLUSIONS the Brazilian scenario shows regional inequalities regarding maternal mortality. It presents hemorrhaging as a symptom and not as a cause of death.
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Gipson MG, Smith MT. Endovascular therapies for primary postpartum hemorrhage: techniques and outcomes. Semin Intervent Radiol 2014; 30:333-9. [PMID: 24436559 DOI: 10.1055/s-0033-1359726] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Interventional radiologists are often consulted for acute management of hemorrhagic complications in obstetric and gynecologic patients. The aim of this article is to review the common indications for vascular embolization in obstetric and gynecologic emergencies, specifically in the setting of primary postpartum hemorrhage, and to discuss the technique and outcomes of endovascular treatment.
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Affiliation(s)
- Matthew G Gipson
- Division of Interventional Radiology, Department of Radiology, University of Colorado, Denver Anschutz Medical Campus, Aurora, Colorado
| | - Mitchell T Smith
- Division of Interventional Radiology, Department of Radiology, University of Colorado, Denver Anschutz Medical Campus, Aurora, Colorado
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