Table of Contents
What interventions should be implemented for postpartum hemorrhage?
External uterine massage and bimanual compression are generally used as first-line treatments. These compression techniques encourage uterine contractions that counteract atony and assist with expulsion of retained placenta or clots. Aortic compression is another compression technique that has been used for severe PPH.
What is the most important intervention for treating postpartum hemorrhage?
Oxytocin (Pitocin) is the first choice for prevention of postpartum hemorrhage because it is as effective or more effective than ergot alkaloids or prostaglandins and has fewer side effects.
What is uterine artery embolization for postpartum hemorrhage?
Uterine artery embolization (UAE) is a minimally invasive treatment used to stop serious pelvic bleeding. The cause of such bleeding could be uterine fibroids (noncancerous tumors inside the uterus), trauma, malignant (cancerous) gynecological tumors, or hemorrhage following childbirth, among other conditions.
What medications are used for prevention and treatment of postpartum hemorrhage?
The medications most commonly used in PPH management are uterotonic agents. These medications include oxytocin (Pitocin®), misoprostol (Cytotec®), methylergonovine maleate (Methergine®,), carboprost tromethamine (Hemabate®), and dinoprostone (Prostin E2®). All of these medications are available in the United States.
Why is uterine artery embolization done?
The main reason to have a uterine fibroid embolization is to treat uterine fibroid tumors that are causing pain or other problems. Nearly all fibroid tumors are benign or not cancerous. It is rare to have a cancerous fibroid. About a third to a half of women of childbearing age have fibroids.
What medication is contraindicated in postpartum hemorrhage?
Contraindications: The only postpartum contraindication to use of oxytocin would be hypersensitivity to the drug. Methergine® (methylergonovine maleate): Methergine is a semi-synthetic ergot alkaloid that is FDA-approved for routine management of the third stage of labor and postpartum atony.
Which of the following medications are used during postpartum hemorrhage due to uterine atony?
Medications used for postpartum hemorrhage secondary to Uterine atony include the following: Oxytocin (Pitocin) can be given IV 10 to 40 units per 1000 ml or 10 units intramuscularly (IM). The rapid undiluted infusion may cause hypotension. Methylergonovine (Methergine) given IM 0.2 mg.
How is uterine embolization done?
The procedure involves inserting a catheter through the groin, maneuvering it through the uterine artery, and injecting the embolic agent into the arteries that supply blood to the uterus and fibroids. As the fibroids die and begin to shrink, the uterus fully recovers.
How embolization is done?
Embolization is performed by placing a small catheter inside the blood vessels that supply the area that is bleeding. Carefully navigating the catheter, under image guidance, to the safest and farthest point, a variety of different materials can then be used to block the bleeding vessels.
What is embolization procedure?
(EM-boh-lih-ZAY-shun) A procedure that uses particles, such as tiny gelatin sponges or beads, to block a blood vessel. Embolization may be used to stop bleeding or to block the flow of blood to a tumor or abnormal area of tissue.
What Is interventional embolization?
Embolization is an interventional procedure in which we occlude, or block, blood vessels that supply tumors with blood. This approach is especially useful for tumors that are difficult or impossible to remove surgically.
What is the purpose of embolization?
Embolization is a minimally invasive treatment, which is usually used to treat benign (non-cancerous) masses in the kidney. To embolize means to block an artery or vein. During an embolization procedure, small particles are injected through a catheter into a mass.
How is pelvic artery embolization used to treat postpartum hemorrhage (PPH)?
Pelvic artery embolization is safe and effective, and is the first-line therapy for medically refractory PPH. A thorough knowledge of pelvic arterial anatomy is critical. Recognition of variant anatomy can prevent therapeutic failure. Pelvic embolization is minimally invasive, has a low complication rate, spares the uterus, and preserves fertility.
How is postpartum hemorrhage (PPH) treated with fluoroscopy?
A new angiographic approach for the treatment of postpartum hemorrhage has emerged over the last 30 years. Uterine arterial embolization under fluoroscopic guidance is effective but requires that experienced personnel and facilities for interventional vascular radiology are available at the hospital or close by.
What is the initial intervention in the treatment of postpartum hemorrhage?
In patients who are hemorrhaging, the initial intervention is resuscitation and stabilization. After vaginal delivery, massage, uterotonic drugs, cavity and soft tissue examination, bimanual compression, and tamponade of the uterus should be tried first.
What are the causes of postpartum hemorrhage (PPH)?
Defined as greater than 500 mL blood loss after vaginal delivery, and greater than 1,000 mL blood loss after cesarean delivery, PPH has many causes, including uterine atony, lower genital tract lacerations, coagulopathy, and placental anomalies. Correction of coagulopathy and identification of the cause of bleeding are mainstays of treatment.