Postpartum Hemorrhage Treated with Gelfoam Slurry Embolization Using the Superselective Technique: Immediate Results and 1-Month MRI Follow-up

Pellerin, Olivier; Bats, Anne-Sophie; Primio, Massimiliano Di; Palomera-Ricco, Ana; Pinot de Villechenon, Gabrielle; others, and

doi:10.1007/S00270-012-0355-7

Title: Postpartum Hemorrhage Treated with Gelfoam Slurry Embolization Using the Superselective Technique: Immediate Results and 1-Month MRI Follow-up

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Abstract

To evaluate the efficacy and safety of superselective embolization of the uterine arteries in a postpartum hemorrhage. Between November 2004 and January 2011, a total of 44 consecutive women (median {+-} standard deviation age 34 {+-} 3 years, range 23-41 years) were referred to our institution for postpartum intractable hemorrhage management. All patients were embolized with a microcatheter that was placed deep into the uterine arteries upstream of the cervical arteries. The embolic agent was a mixture of contrast medium and 5 Multiplication-Sign 5 Multiplication-Sign 5 cm pieces of gelfoam (Gelita-Spon) modified into a gelatin emulsion as follows: rapid mixing through a three-way stopcock with two 2.5-ml syringes. A 1-ml syringe was used for injection. One month after embolization, all patients underwent magnetic resonance imaging and clinical examination. Technical and clinical success was obtained in all cases. Thirty-five patients experienced bleeding related to poor retraction of the uterus, 7 patients because of a tear of the cervix and 2 because of a vaginal hematoma. Pre- and postembolization red blood cell transfusions were (mean {+-} standard deviation [SD]) 6 {+-} 1.2 (range 3-8) U and 2 {+-} 0.7 (range 2-4) U, respectively. One-month magnetic resonance imaging follow-up revealed no sign ofmore »« less

Authors:

Pellerin, Olivier ^[1]; Bats, Anne-Sophie ^[2]; Primio, Massimiliano Di; Palomera-Ricco, Ana ^[1]; Pinot de Villechenon, Gabrielle ^[3]; others, and

Universite Paris Descartes, Sorbonne Paris Cite, Faculte de Medecine - Assistance Publique-Hopitaux de Paris - Hopital Europeen Georges-Pompidou, Paris, France, Interventional Radiology Department (France)
Universite Paris Descartes, Sorbonne Paris Cite, Faculte de Medecine - Assistance Publique-Hopitaux de Paris - Hopital Europeen Georges-Pompidou, Paris, France, Gynecologic and Oncologic Surgery Department (France)
Universite Paris Descartes, Sorbonne Paris Cite, Faculte de Medecine - Assistance Publique-Hopitaux de Paris - Hopital Europeen Georges-Pompidou, Paris, France, Anesthesia and Surgical Intensive Care Unit (France)

Publication Date:: Fri Feb 15 00:00:00 EST 2013

OSTI Identifier:: 22156525

Resource Type:: Journal Article

Journal Name:: Cardiovascular and Interventional Radiology

Additional Journal Information:: Journal Volume: 36; Journal Issue: 1; Other Information: Copyright (c) 2013 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551

Country of Publication:: United States

Language:: English

Subject:: 62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; BLOOD CELLS; EMULSIONS; GELATIN; HEMATOMAS; HEMORRHAGE; MAGNETIC RESONANCE; NECROSIS; NMR IMAGING; PATIENTS; SAFETY; SLURRIES; THROMBOSIS; TRANSFUSIONS; UTERUS; VEINS; WOMEN

Citation Formats


                    Pellerin, Olivier, Bats, Anne-Sophie, Primio, Massimiliano Di, Palomera-Ricco, Ana, Pinot de Villechenon, Gabrielle, and others, and. Postpartum Hemorrhage Treated with Gelfoam Slurry Embolization Using the Superselective Technique: Immediate Results and 1-Month MRI Follow-up.  United States: N. p., 2013. 
        Web.  doi:10.1007/S00270-012-0355-7.

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                    Pellerin, Olivier, Bats, Anne-Sophie, Primio, Massimiliano Di, Palomera-Ricco, Ana, Pinot de Villechenon, Gabrielle, & others, and. Postpartum Hemorrhage Treated with Gelfoam Slurry Embolization Using the Superselective Technique: Immediate Results and 1-Month MRI Follow-up.  United States.  https://doi.org/10.1007/S00270-012-0355-7

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                    Pellerin, Olivier, Bats, Anne-Sophie, Primio, Massimiliano Di, Palomera-Ricco, Ana, Pinot de Villechenon, Gabrielle, and others, and. 2013.  
        "Postpartum Hemorrhage Treated with Gelfoam Slurry Embolization Using the Superselective Technique: Immediate Results and 1-Month MRI Follow-up".  United States.  https://doi.org/10.1007/S00270-012-0355-7.

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@article{osti_22156525,

  title        = {Postpartum Hemorrhage Treated with Gelfoam Slurry Embolization Using the Superselective Technique: Immediate Results and 1-Month MRI Follow-up},

  author       = {Pellerin, Olivier and Bats, Anne-Sophie and Primio, Massimiliano Di and Palomera-Ricco, Ana and Pinot de Villechenon, Gabrielle and others, and},

  abstractNote = {To evaluate the efficacy and safety of superselective embolization of the uterine arteries in a postpartum hemorrhage. Between November 2004 and January 2011, a total of 44 consecutive women (median {+-} standard deviation age 34 {+-} 3 years, range 23-41 years) were referred to our institution for postpartum intractable hemorrhage management. All patients were embolized with a microcatheter that was placed deep into the uterine arteries upstream of the cervical arteries. The embolic agent was a mixture of contrast medium and 5 Multiplication-Sign 5 Multiplication-Sign 5 cm pieces of gelfoam (Gelita-Spon) modified into a gelatin emulsion as follows: rapid mixing through a three-way stopcock with two 2.5-ml syringes. A 1-ml syringe was used for injection. One month after embolization, all patients underwent magnetic resonance imaging and clinical examination. Technical and clinical success was obtained in all cases. Thirty-five patients experienced bleeding related to poor retraction of the uterus, 7 patients because of a tear of the cervix and 2 because of a vaginal hematoma. Pre- and postembolization red blood cell transfusions were (mean {+-} standard deviation [SD]) 6 {+-} 1.2 (range 3-8) U and 2 {+-} 0.7 (range 2-4) U, respectively. One-month magnetic resonance imaging follow-up revealed no sign of ischemic myometrium or necrosis, and no instances of uterine rupture and no pelvic vein thrombosis. Incidental findings included two small intramyometrial hematic collections. All uterine arteries were patent via magnetic resonance angiography. Seventeen patients had concomitant fibroids, all of which appeared hypovascular. This technique permits good, safe clinical results with no marked damage to the uterine arteries or the uterus itself.},

  doi          = {10.1007/S00270-012-0355-7},

  url          = {https://www.osti.gov/biblio/22156525},
  journal      = {Cardiovascular and Interventional Radiology},

  issn         = {0174-1551},

  number       = 1,

  volume       = 36,

  place        = {United States},

  year         = {Fri Feb 15 00:00:00 EST 2013},

  month        = {Fri Feb 15 00:00:00 EST 2013}

}

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