Swati SHİVHARE
(All India India Institute of Medical Sciences, Department of Obstetrics and Gynecology, New Delhi, India)
Jyoti MEENA
(All India India Institute of Medical Sciences, Department of Obstetrics and Gynecology, New Delhi, India)
Sunesh KUMAR
(All India India Institute of Medical Sciences, Department of Obstetrics and Gynecology, New Delhi, India)
Shivanand GAMANAGATTİ
(All India India Institute of Medical Sciences, Department of Radiology, New Delhi, India)
Yıl: 2021Cilt: 18Sayı: 2ISSN: 2149-9322 / 2149-9330Sayfa Aralığı: 163 - 166İngilizce

0 0
Endovascular management of episiotomy site hematoma: Two cases and a brief review
Episiotomy site hematoma, though uncommon, can be associated with serious maternal morbidity. It arises mostly due to tissue trauma or injury to blood vessels, leading to the formation of a pseudoaneurysm. Sometimes, when surgical management fails, embolization of the bleeding vessel is a lifesaving option. Here, we report two cases of episiotomy site hematoma that required selective arterial embolization for management, following the failure of surgical management. A 28-year-old G6A5 woman underwent forceps delivery following which she developed a 6*6-cm right-sided vulvovaginal hematoma at the episiotomy site. After failed surgical management, arterial embolization was performed and hemostasis was achieved. A 26-year-old P2L2 woman with a history of surgical exploration for episiotomy site hematoma, presented postdelivery on postpartum day seven with profuse vaginal bleeding. Her computed tomography angiogram revealed a pseudoaneurysm of around 2.1*1 cm in length with a vaginal hematoma of 4*5 cm. Selective artery embolization performed and complete hemostasis was achieved with no complications. Selective arterial embolization is a safe therapeutic option for episiotomy site hematoma, especially if surgical management fails
Dergititle.paper.fact_presentationErişime Açık
  • 1. Cooper BC, Hocking-Brown M, Sorosky JI, Hansen WF. Pseudoaneurysm of the uterine arteryrequiring bilateral uterine artery embolization. J Perinatol 2004;24:560-2.
  • 2. Gondo S, Urushiyama D, Yoshizato T, Kora S, Maehara M, Kondo H, et al. The successful detection of postpartum unruptured vaginal pseudoaneurysm using ultrasonography: a case report. Springerplus 2014;3:482.
  • 3. Nagayama C, Gibo M, Nitta H, Uezato T, Hirakawa M, Masamoto H et al. Rupture of pseudoaneurysm after vaginal delivery successfully treated by selective arterial embolization. Arch Gynecol Obstet 2011;283:37-40.
  • 4. Takagi K, Akashi K, Horiuchi I, Nakamura E, Samejima K, Ushijima J, et al. Managing vulvovaginal hematoma by arterial embolization as first-line hemostatic therapy. Taiwan J Obstet Gynecol 2017;56:224-6.
  • 5. Distefano M, Casarella L, Amoroso S, Di Stasi C, Scambia G, Tropeano G. Selectivearterial embolization as a first-line treatment for postpartum hematomas. Obstet Gynecol 2013;121:443-7.
  • 6. Ojala K, Perala J, Kariniemi J, Ranta P, Raudaskoski T, Tekay A. Arterial embolizationand prophylactic catheterization for the treatment for severe obstetrichemorrhage. Acta Obstet Gynecol Scand 2005;84:1075-80.
  • 7. Brown BJ, Heaston DK, Poulson AM, Gabertet HA, Mineau DE, Miller FJ Jr. Uncontrollable postpartum bleeding: a new approachto hemostasis through angiographic arterial embolization. Obstet Gynecol 1979;54:361-5.
  • 8. Villella J, Garry D, Levine G, Glanz S, Figueroa R, Maulik D. Postpartum angiographicembolization for vulvovaginal hematoma. A report of two cases. J Reprod Med 2001;46:65-7.
  • 9. Lee SM, Shin JH, Shim JJ, Yoon KW, Cho YJ, Kim JW, et al. Postpartum haemorrhage due to genital tract injury after vaginal delivery: safety and efficacy of transcatheter arterial embolisation. Eur Radiol 2018;28:4800-9.
  • 10. Leaf MC, Schmidt L, Serna-Gallegos T, Lane F. A ruptured vulvar labial artery pseudoaneurysm causes a secondary postpartum hemorrhage: a case report. Case Rep Womens Health 2020;26:e00184. doi: 10.1016/j.crwh.2020.e00184.
  • 11. Mahmoud MZ, Al-Saadi M, Abuderman A, Alzimami KS, Alkhorayef M, Almagli B, et al. “To-and-fro” waveform in the diagnosis ofarterialpseudoaneurysms. World J Radiol 2015;7:89-99.

TÜBİTAK ULAKBİM Ulusal Akademik Ağ ve Bilgi Merkezi Cahit Arf Bilgi Merkezi © 2019 Tüm Hakları Saklıdır.