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BioMed Research International
Volume 2017, Article ID 1562432, 7 pages
https://doi.org/10.1155/2017/1562432
Research Article

Emergent Uterine Arterial Embolization Using N-Butyl Cyanoacrylate in Postpartum Hemorrhage with Disseminated Intravascular Coagulation

1Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Japan
2Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan
3Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan

Correspondence should be addressed to Soichiro Obata; pj.ca.uc-amahokoy@ataboos

Received 10 June 2016; Revised 20 September 2016; Accepted 4 January 2017; Published 30 January 2017

Academic Editor: Hiroshi Tanaka

Copyright © 2017 Soichiro Obata et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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%, ) or ISTH DIC score (54.5% versus 76.5%, ). UAE using NBCA may be a useful first-choice treatment for PPH with DIC.