Postpartum hemorrhage: Clinical and radiologic aspects

Area of Science:

• Radiology
• Obstetrics & Gynecology
• Maternal Health

Background:

• Postpartum hemorrhage (PPH) is a critical obstetric emergency and a primary cause of maternal morbidity.
• Common causes include uterine atony, lacerations, retained products, and coagulopathy.
• Initial diagnosis relies on clinical assessment, lab tests, and ultrasound.

Purpose of the Study:

• To review the role of advanced imaging modalities in diagnosing and characterizing postpartum hemorrhage.
• To highlight how CT and MR imaging can aid in difficult PPH cases.
• To correlate radiologic findings with clinical information for improved patient management.

Main Methods:

• Review of computed tomography (CT) and magnetic resonance (MR) imaging findings in PPH.
• Correlation of imaging results with clinical presentations and diagnoses.
• Emphasis on CT for identifying arterial hemorrhage and uterine atony.
• MR imaging's role in evaluating retained products of conception when ultrasound is inconclusive.

Main Results:

• CT accurately identifies arterial bleeding via contrast extravasation, guiding angiographic interventions.
• CT can diagnose uterine atony in unclear clinical scenarios by detecting extravasation or hematoma.
• CT aids in diagnosing alternative conditions like hematomas and uterine rupture.
• MR imaging complements ultrasound for retained products of conception.

Conclusions:

• Advanced imaging, particularly CT and MR, plays a crucial role in diagnosing and characterizing complex PPH cases.
• Radiologic findings are vital for differentiating causes of PPH and guiding timely, appropriate treatment.
• Integrating imaging with clinical data enhances diagnostic accuracy and patient outcomes in PPH management.