title: Emergent Uterine Arterial Embolization Using N-Butyl Cyanoacrylate in Postpartum Hemorrhage with Disseminated Intravascular Coagulation.
abstract: Although it is widely accepted that uterine artery embolization (UAE) is an effective therapeutic strategy for postpartum hemorrhage (PPH), no consensus has been reached regarding the efficacy of UAE in patients with PPH with disseminated intravascular coagulation (DIC). This single-center retrospective cohort study included patients treated with UAE using NBCA for PPH between 2010 and 2015. The patients were divided into DIC and non-DIC groups, according to the obstetrical DIC score and the overt DIC diagnostic criteria issued by the International Society of Thrombosis and Haemostasis (ISTH), and their clinical outcomes were compared. There were 28 patients treated with UAE using NBCA. Complete hemostasis was achieved by UAE in 19 of 28 patients. In eight of nine patients with unsuccessful hemostasis, surgical hemostatic interventions were performed after UAE, and hemostasis was achieved in seven patients. UAE using NBCA showed no significant intergroup differences in complete hemostasis according to the presence or absence of DIC based on obstetrical DIC score (70% versus 62.5%,P= 1.000) or ISTH DIC score (54.5% versus 76.5%,P= 0.409). UAE using NBCA may be a useful first-choice treatment for PPH with DIC.
authors.affiliation: Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Soichiro
authors.identifier: 0000-0002-4107-0844
authors.initials: S
authors.lastname: Obata
authors.affiliation: Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Michi
authors.initials: M
authors.lastname: Kasai
authors.affiliation: Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Kasai
authors.affiliation: Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Seki
authors.affiliation: Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Zenjiro
authors.initials: Z
authors.lastname: Sekikawa
authors.affiliation: Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Torimoto
authors.affiliation: Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Takebayashi
authors.affiliation: Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan.
authors.forename: Fumiki
authors.initials: F
authors.lastname: Hirahara
authors.affiliation: Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Shigeru
authors.identifier: 0000-0001-5307-575X
authors.initials: S
authors.lastname: Aoki
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004211:Disseminated Intravascular Coagulation / Q000150:complications* / Q000628:therapy*; D004659:Enbucrilate / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000628:therapy*; D055988:Uterine Artery / Q000187:drug effects*; D055357:Uterine Artery Embolization / Q000379:methods*; D055815:Young Adult
chemical_list: D004659:Enbucrilate