Postpartum hemorrhage: Clinical and radiologic aspects.
Postpartum hemorrhage (PPH) is a potentially life threatening condition, and it remains the leading cause of maternal morbidity. Uterine atony, lower genital tract lacerations, uterine rupture or inversion, retained products of conception and underlying coagulopathy are some of the common causes of PPH. Most conditions can be diagnosed based on clinical and laboratory evaluation supplemented by ultrasound information. Computed tomography (CT) or magnetic resonance (MR) imaging can provide information for the detection, localization and characterization of PPH in some difficult cases. CT can accurately demonstrate the anatomic location of significant arterial hemorrhage as sites of intravenous contrast material extravasation, which can be as a guide for angiographic intervention. The presence of focal or diffuse intravenous contrast extravasation or a hematoma within the enlarged postpartum uterine cavity on CT can help the diagnosis of uterine atony when the clinical diagnosis of uterine atony is unclear. CT can also provide the information of other alternative conditions such as a puerperal genital hematoma, uterine rupture and concealed hematoma in other sites. MR imaging may be considered as a valuable complement to ultrasound where the ultrasound findings are inconclusive in the diagnosis and differential diagnosis of retained products of conception. Knowledge of the various radiologic appearances of PPH and the correlation with clinical information can ensure correct diagnosis and appropriate and prompt treatment planning in the patients with PPH.
Lee
Nam Kyung
NK
Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, #1-10, Ami-Dong, Seo-Gu, Busan 602-739, Republic of Korea.
Kim
Suk
S
Lee
Jun Woo
JW
Sol
Yu Li
YL
Kim
Chang Won
CW
Hyun Sung
Kim
K
Jang
Ho Jin
HJ
Suh
Dong Soo
DS
D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D006473:Postpartum Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011247:Pregnancy; D014057:Tomography, X-Ray Computed