Postpartum hemorrhage: what every radiologist needs to know.

Area of Science:

• Obstetrics and Gynecology
• Vascular Surgery
• Interventional Radiology

Background:

• Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality.
• Defined as >500 mL blood loss, PPH can lead to shock or death.
• Uterine atony, the failure of the myometrium to contract post-placental delivery, is the most frequent cause.

Purpose of the Study:

• To review the established and emerging treatment modalities for postpartum hemorrhage.
• To highlight the safety and efficacy of pelvic arterial embolization as a treatment option.

Main Methods:

• Review of traditional PPH management including oxytocin and uterine massage.
• Exploration of surgical interventions like uterine packing, suture techniques, and artery ligation.
• Evaluation of the angiographic approach, specifically pelvic arterial embolization.

Main Results:

• Pelvic arterial embolization has emerged as a safe and effective treatment for PPH over the past 30 years.
• This interventional radiology technique provides an alternative when conservative measures are insufficient.

Conclusions:

• Timely cessation of bleeding is crucial to prevent consumptive coagulopathy and end-organ damage in PPH.
• Pelvic arterial embolization is a valuable tool in the management of refractory postpartum hemorrhage.