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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.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title biomed research international
Publication Year Start




PMID- 28251148
OWN - NLM
STAT- MEDLINE
DA  - 20170302
DCOM- 20170313
LR  - 20170313
IS  - 2314-6141 (Electronic)
VI  - 2017
DP  - 2017
TI  - Emergent Uterine Arterial Embolization Using N-Butyl Cyanoacrylate in Postpartum 
      Hemorrhage with Disseminated Intravascular Coagulation.
PG  - 1562432
LID - 10.1155/2017/1562432 [doi]
AB  - 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.
FAU - Obata, Soichiro
AU  - Obata S
AUID- ORCID: 0000-0002-4107-0844
AD  - Perinatal Center for Maternity and Neonate, Yokohama City University Medical
      Center, Yokohama, Japan.
FAU - Kasai, Michi
AU  - Kasai M
AD  - Perinatal Center for Maternity and Neonate, Yokohama City University Medical
      Center, Yokohama, Japan.
FAU - Kasai, Junko
AU  - Kasai J
AD  - Perinatal Center for Maternity and Neonate, Yokohama City University Medical
      Center, Yokohama, Japan.
FAU - Seki, Kazuo
AU  - Seki K
AD  - Perinatal Center for Maternity and Neonate, Yokohama City University Medical
      Center, Yokohama, Japan.
FAU - Sekikawa, Zenjiro
AU  - Sekikawa Z
AD  - Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan.
FAU - Torimoto, Izumi
AU  - Torimoto I
AD  - Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan.
FAU - Takebayashi, Shigeo
AU  - Takebayashi S
AD  - Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan.
FAU - Hirahara, Fumiki
AU  - Hirahara F
AD  - Department of Obstetrics and Gynecology, Yokohama City University Hospital,
      Yokohama, Japan.
FAU - Aoki, Shigeru
AU  - Aoki S
AUID- ORCID: 0000-0001-5307-575X
AD  - Perinatal Center for Maternity and Neonate, Yokohama City University Medical
      Center, Yokohama, Japan.
LA  - eng
PT  - Journal Article
DEP - 20170130
PL  - United States
TA  - Biomed Res Int
JT  - BioMed research international
JID - 101600173
RN  - F8CEP82QNP (Enbucrilate)
SB  - IM
MH  - Adult
MH  - Cohort Studies
MH  - Disseminated Intravascular Coagulation/*complications/*therapy
MH  - Enbucrilate/*pharmacology
MH  - Female
MH  - Humans
MH  - Postpartum Hemorrhage/*therapy
MH  - Uterine Artery/*drug effects
MH  - Uterine Artery Embolization/*methods
MH  - Young Adult
PMC - PMC5303842
COI - The authors declare that they have no competing interests.
EDAT- 2017/03/03 06:00
MHDA- 2017/03/14 06:00
CRDT- 2017/03/03 06:00
PHST- 2016/06/10 [received]
PHST- 2016/09/20 [revised]
PHST- 2017/01/04 [accepted]
AID - 10.1155/2017/1562432 [doi]
PST - ppublish
SO  - Biomed Res Int. 2017;2017:1562432. doi: 10.1155/2017/1562432. Epub 2017 Jan 30.

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