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主要和次要产后出血:对内血管方法的逻辑性审查

Alberto Alonso-Burgos¹, Ignacio Díaz-Lorenzo², Laura Muñoz-Saá³

¹Radiology Department, Vascular Surgery and Interventional Radiology Unit, University Clinic of Navarra, Clínica Universidad de Navarra, Marquesado de Santa Marta 1, 28027, Madrid, Spain. alonsoburgosmd@gmail.com.

CVIR endovascular

|February 13, 2024

概括

内血管治疗,如子宫动脉栓塞,为产后出血 (PPH) 提供有效的管理. 本综述探讨了各种PPH原因的这些先进技术,改善了母亲的结果.

科学领域:

产科和妇科产科和妇科
干预性放射学干预性放射学
血管外科血管外科

背景情况:

产后出血 (PPH) 是全球主要的孕产妇死亡原因.
PPH可以是初级的 (24小时内) 或二次的 (24小时至6周产后).
常见的原因包括子宫缩,创伤,胎盘增殖谱 (PAS) 和保留的受孕产物 (RPOC).

研究的目的:

对初级和二级PPH的内血管治疗选择进行全面审查.
专注于应用这些技术来管理子宫,创伤,PAS和RPOC.
突出成像在PPH诊断和治疗规划中的作用.

主要方法:

对PPH的内血管干预现有文献的综述.
讨论诊断成像方式:超声波,CT和MRI.
对子宫动脉栓塞 (UAE) 技术和栓塞剂的详细探索.
强调了解盆腔血管解剖学,以确保安全的阿联.

主要成果:

子宫动脉栓塞 (UAE) 是一种标准的,有效的 (>85%的成功率) 和耐火PPH的安全干预措施.
图像检查在诊断PPH原因方面发挥着至关重要的作用,除了子宫缩外.
针对PAS需要定制的阿联方法,对特定的出血点或具有AVM类模式的RPOC进行选择性栓塞是必要的.

结论:

将干预性放射技术纳入PPH临床指南至关重要.
在分娩期间,产科和干预放射学团队之间的合作是必不可少的.
内血管治疗为治疗复杂PPH病例提供了对手术的重要替代方案.

关键词:

血栓形成的过程中发生了栓塞.胎盘活动胎盘活动产后出血症产后出血症保留产品的概念是保留的产品.子宫的缩,子宫的缩.

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