A New Protocol for Determining Intervention with Trans-Catheter Arterial Embolization or Surgical Hemostasis for Obstetric Hemorrhage ()
ABSTRACT
Objectives: The aim of this study is to
introduce protocols for choosing trans-arterial embolization (TAE) or surgical
hemostasis as an initial therapy for obstetric hemorrhage. Materials and
Methods: From 2002 to 2011 at our hospital, the medical records of the patients
who underwent TAE or surgical hemostasis for obstetric hemorrhage were reviewed
to assess the following data: The causes of obstetric hemorrhage, Shock Index
(SI) and obstetrical disseminated intra-vascular coagulation (DIC) score,
amount of bleeding, transfusion, and operation time. Results: Twenty-five
patients underwent TAE and six underwent surgical hemostasis. SI and
obstetrical DIC score of the TAE group were 1.0 (0.4 - 2.2) and 6.0 (1 - 32),
respectively. They were significantly lower than those of the surgical
hemostasis group (SI: 1.6, obstetrical DIC score: 12.5, p < 0.05). Though
the hemorrhage could be controlled sufficiently in 23 cases of the TAE group, 5
cases went into shock during TAE. The SI and obstetrical DIC score of shock
group were 1.2 (1 - 2) and 10 (2 - 32), respectively. Conclusion: Though TAE is
a useful therapy to control obstetric inevitable hemorrhage, special attention
should be paid to the vital signs during TAE, especially in cases where SI
and/or obstetrical DIC score are higher than 1.2 and 10, respectively.
Share and Cite:
Myoga, M. , Yoshimura, K. and Hachisuga, T. (2015) A New Protocol for Determining Intervention with Trans-Catheter Arterial Embolization or Surgical Hemostasis for Obstetric Hemorrhage.
Open Journal of Obstetrics and Gynecology,
5, 128-134. doi:
10.4236/ojog.2015.53017.
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