scholarly journals Intra-arterial Balloon Occlusion to Reduce Operative Bleeding for Placenta Previa Accreta Spectrum

2021 ◽  
Author(s):  
Yoshihiko Murayama ◽  
Hiroyuki Seki ◽  
Satoru Takeda
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Damage Control ◽  
Hypovolemic Shock ◽  
Significant Risk ◽  
Damage Control Surgery ◽  
Massive Hemorrhage ◽  
Balloon Occlusion ◽  
Trained Staff ◽  
Previous Cesarean

AbstractCesarean section for placenta previa accreta spectrum carries a significant risk of massive hemorrhage. Hence, it is necessary to understand the various hemostatic procedures, damage control surgery and resuscitation for massive hemorrhage, and systemic management against hypovolemic shock and coagulopathy. In cases of placenta previa with previous cesarean section, the operation should be performed in a tertiary medical facility with well-trained staff and blood availability for transfusion. Preoperative placement of an intra-arterial balloon occlusion catheter in the common iliac artery or aorta is useful for preventing massive hemorrhage.

scholarly journals Pathological Findings in a Case of Failed Uterine Artery Embolization for Placenta Previa

2013 ◽  
Vol 4 ◽  
pp. JCM.S11317 ◽  
Author(s):  
Natsuko Wada ◽  
Daisuke Tachibana ◽  
Kayoko Nakagawa ◽  
Hiroyuki Terada ◽  
Akemi Nakano ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Placenta Previa ◽  
Hypovolemic Shock ◽  
Massive Bleeding ◽  
Massive Hemorrhage ◽  
Gelatin Sponge ◽  
Pathological Findings ◽  
Artery Embolization

The reported success rate of uterine artery embolization (UAE) for obstetrical hemorrhage is more than 90%. We experienced a case of failed UAE for postpartum hemorrhage, although an embolic particle was found pathologically in the uterine vessels without coagulation. A 42-year-old woman (gravida 7, para 2) with placenta previa had genital bleeding at 35 weeks of gestation, and cesarean section was performed. We immediately added UAE aiming to reduce massive bleeding after the cesarean section, successful embolization of the bilateral uterine arteries and internal iliac arteries were confirmed by angiography regardless the vital sign was recovered with an appropriate amount of transfusion; the massive bleeding recurred after 1 hour of UAE. Hysterectomy was performed and pathological findings of the uterus showed that there was no coagulation in the vessels, which was supposed to be observed by the effect of gelatin sponge. In addition, despite the fact that no coagulation was found, only one gelatin sponge was found in 16 slices of the uterine wall specimens. We speculate that thrombotic materials were caught in vasoconstricted vessels triggered by hypovolemic shock due to acute blood loss, and then the gelatin sponge could be washed out after recovering to normalized circulation status leading to recurrent massive hemorrhage.

scholarly journals Damage control in the emergency department, a bridge to life

2021 ◽  
Vol 52 (2) ◽  
pp. e4004801
Author(s):  
Laureano Quintero ◽  
Juan Jose Melendez-Lugo ◽  
Helmer Emilio Palacios-Rodríguez ◽  
Natalia Padilla ◽  
Luis Fernando Pino ◽  
...  
Keyword(s):  
Emergency Department ◽  
Trauma Patient ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Hemodynamic Instability ◽  
Massive Hemorrhage ◽  
Severely Injured ◽  
Airway Injury ◽  
Hemostatic Resuscitation ◽  
Altered State Of Consciousness

Patients with hemodynamic instability have a sustained systolic blood pressure less or equal to 90 mmHg, a heart rate greater or equal to 120 beats per minute and an acute compromise of the ventilation/oxygenation ratio and/or an altered state of consciousness upon admission. These patients have higher mortality rates due to massive hemorrhage, airway injury and/or impaired ventilation. Damage control resuscitation is a systematic approach that aims to limit physiologic deterioration through a group of strategies that address the physiologic debt of trauma. This article aims to describe the experience earned by the Trauma and Emergency Surgery Group (CTE) of Cali, Colombia in the management of the severely injured trauma patient in the emergency department following the basic principles of damage control surgery. Since bleeding is the main cause of death, the management of the severely injured trauma patient in the emergency department requires a multidisciplinary team, which should perform damage control maneuvers aimed at rapidly control bleeding, hemostatic resuscitation and/or prompt transfer to the operating room, if required.

Surgical Complications and Causes of Death in Trauma Patients that Require Temporary Abdominal Closure

2005 ◽  
Vol 71 (3) ◽  
pp. 219-224 ◽  
Author(s):  
JosÉ A. Montalvo ◽  
JosÉ A. Acosta ◽  
Pablo RodrÍguez ◽  
Kathia Alejandro ◽  
AndrÉs SÁrraga
Keyword(s):  
Surgical Complications ◽  
Causes Of Death ◽  
Surgical Complication ◽  
Damage Control ◽  
Multiple Logistic Regression Analysis ◽  
Hypovolemic Shock ◽  
Damage Control Surgery ◽  
Trauma Patients ◽  
Temporary Abdominal Closure ◽  
Abdominal Closure

Temporary abdominal closure (TAC) has increasingly been employed in the management of severely injured patients to avoid abdominal compartment syndrome (ACS) and as part of damage control surgery (DCS). Although the use of TAC has received great interest, few data exist describing the morbidity and mortality associated with its use in trauma victims. The main goal of this study is to describe the incidence of surgical complications following the use of TAC as well as to define the mortality associated with this procedure. A retrospective review of patients admitted to a state-designated level 1 trauma center from April 2000 to February 2003 was performed. Inclusion criteria were age >18 years, traumatic injury, and need for exploratory laparotomy and use of TAC. A total of 120 patients were included in the study. The overall mortality of trauma patients requiring TAC was 59.2 per cent. The most common causes of death were acute inflammatory process (50.7%), followed by hypovolemic shock (43.7%). The incidence of surgical complications was 26.6 per cent. Intra-abdominal abscesses were the most frequent surgical complication (10%). After multiple logistic regression analysis, increasing age and a numerically greater initial base deficit were found to be independent predictors of mortality in trauma patients that require TAC.

Predisposing factors for massive hemorrhage during Cesarean section in patients with placenta previa

2009 ◽  
Vol 34 (1) ◽  
pp. 80-84 ◽  
Author(s):  
J. Hasegawa ◽  
R. Matsuoka ◽  
K. Ichizuka ◽  
T. Mimura ◽  
A. Sekizawa ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Massive Hemorrhage ◽  
Predisposing Factors
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