RESUMO
OBJECTIVE: This study was to determine the long-term outcomes of arterial pelvic embolization for intractable postpartum hemorrhage and particularly its effect on menses, fertility, and outcomes of subsequent pregnancies. STUDY DESIGN: Fifty-six consecutive patients who underwent emergency pelvic arterial embolization for severe postpartum hemorrhage between April 1995 and July 2005 were included in the study. Patients were contacted to obtain information about menses and fertility after pelvic arterial embolization. RESULTS: Thirty-four women (61.8%) were successfully contacted. One patient had a hysterectomy. Thirty women (91%) reported regular menses. Thirteen women (38.3%) had a total of 20 spontaneous pregnancies. Eight pregnancies ended during the first trimester. The 12 other pregnancies (60%) were all normal and all patients delivered vaginally healthy babies with normal weight for gestational age. CONCLUSION: The current study suggests that fertility is not adversely affected by arterial pelvic embolization for intractable postpartum hemorrhage and that women can conceive after the procedure with normal pregnancy outcomes.
Assuntos
Embolização Terapêutica , Fertilidade , Hemorragia Pós-Parto/terapia , Adulto , Feminino , Humanos , Índice de Gravidade de Doença , Adulto JovemRESUMO
BACKGROUND: Spontaneous rupture of uterine vessels during pregnancy is rare and usually involves uteroovarian veins. Presenting symptoms include acute-onset abdominal pain and maternal hypovolemic collapse due to hemoperitoneum. An atypical case of subacute uterine artery rupture at 27 weeks of gestation occurred in a woman with sickle cell disease. CASE: A 28-year-old, nulliparous woman with sickle cell disease was admitted at 27 weeks of gestation for sharp abdominal pain radiating to the right flank. The first diagnosis included acute renal colic and a sickling vasoocclusive crisis. One week after admission the patient experienced paroxysmal, diffuse abdominal pain associated with acute fetal distress requiring an emergency cesarean section. Laparotomy revealed an 800-mL hemoperitoneum. Active bleeding from a ruptured uterine artery was observed and successfully treated by selective suture. CONCLUSION: Spontaneous rupture of the uterine artery during pregnancy may present as a 2-step process.
Assuntos
Anemia Falciforme/complicações , Artérias/patologia , Complicações na Gravidez/patologia , Útero/irrigação sanguínea , Adulto , Feminino , Hemoperitônio/etiologia , Humanos , Gravidez , Ruptura EspontâneaAssuntos
Descolamento Prematuro da Placenta/epidemiologia , Feminino , Humanos , Peru , Gravidez , Fatores de RiscoAssuntos
Líquido Amniótico/citologia , Hibridização in Situ Fluorescente/métodos , Diagnóstico Pré-Natal/métodos , Gêmeos/genética , Adulto , Amniocentese , Proteínas de Ligação a DNA/sangue , Proteínas de Ligação a DNA/genética , Feminino , Proteínas de Grupo de Alta Mobilidade/sangue , Proteínas de Grupo de Alta Mobilidade/genética , Humanos , Cariotipagem , Masculino , Reação em Cadeia da Polimerase , Gravidez , Fatores de Transcrição SOXB1RESUMO
Ultrasound-guided transvaginal follicle aspiration is the standard technique for oocyte retrieval prior to IVF. Complications are rare, but some are potentially serious. We report a case of ureteral injury with acute-onset uro-retroperitoneum in a volunteer oocyte donor. The patient recovered rapidly after ureteral stenting. This case underlines the need for all candidate oocyte donors to receive proper information on serious procedure-related complications.
