Abstract：Objective To explore the clinical features of intractable postpartum hemorrhage, and the efficacy and safety of pelvic artery embolization (PAE) in the treatment of that disease.Methods A total of 19 intractable postpartum hemorrhage patients from Beijing Jishuitan Hospital were included in the study. We collected their clinical data from January 2014 to December 2017. The average age of patients was (30.9±4.5)years, and the average gestational age was (38±2.0)weeks. The participants were divided into two groups according to the mode of delivery, including 7 cases in the vaginal delivery group and 12 cases in the cesarean section group, respectively. We compared the causes, interventions, bleeding, PAE effects and complications of intractable postpartum hemorrhage between the two groups, and analyzed the clinical application and value of PAE.Results Of the 19 patients with intractable postpartum hemorrhage, 4 had soft birth canal injury, 4 had arteriovenous fistula, 6 had uterine fatigue, and 5 had placental factors, respectively. The mode of delivery had no effect on the occurence of intractable postpartum hemorrhage. The number of red blood cells transfused in the vaginal delivery group was greater than that in the cesarean section. All patients with refractory postpartum hemorrhage were treated with uterine contractions, and 9 patients underwent surgical intervention before PAE. 19 patients were embolized with 36 vessels, most of whom were PAE bilateral uterine arteries. 19 patients retained the uterus and recovered regular menstruation. 8 patients developed fever after PAE.ConclusionPAE is effective and safely invasive for the treatment of intractable postpartum hemorrhage. It is the first-line treatment after conservative treatment.
赵亮, 孙丽芳, 郑秀丽, 刘静芳, 郑蓉, 吕青青, 张晗. 盆腔动脉栓塞术治疗难治性产后出血的临床研究[J]. 中国生育健康杂志, 2018, 29(6): 519-523.
ZHAO Liang, SUN Lifang, ZHENG Xiuli, LIU Jingfang, ZHENG Rong, LYU Qingqing. Clinical study of pelvic arterial embolization in the treatment of refractory postpartum hemorrhage. Chinese Journal of Reproductive Health, 2018, 29(6): 519-523.
