Interventional Radiology in Obstetric Emergencies

Suyash Kulkarni; Nitin S Shetty; Anurag Gupta; Saketh Rao; Harshit Bansal

doi:10.5005/jp-journals-10071-24090

Interventional Radiology in Obstetric Emergencies

Indian J Crit Care Med. 2021 Dec;25(Suppl 3):S273-S278. doi: 10.5005/jp-journals-10071-24090.

Authors

Suyash Kulkarni¹, Nitin S Shetty², Anurag Gupta³, Saketh Rao³, Harshit Bansal⁴

Affiliations

¹ Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
² Department of Interventional Radiology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
³ Department of Interventional Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
⁴ Department of Radio-diagnosis, University College of Medical Sciences, New Delhi, India.

Abstract

Postpartum hemorrhage (PPH) is one of the common causes of morbidity as well as mortality among pregnant women. Obstetric hemorrhage embolization (OHE)/uterine artery embolization (UAE) is the preferred treatment for PPH which has failed medical therapy. In cases of placental accreta spectrum (PAS), balloon catheter can be prophylactically placed in internal iliac arteries (IIAs) bilaterally before delivery to enable postpartum control of bleeding. An inferior vena cava (IVC) filter can be placed under fluoroscopy for a pregnant woman with deep vein thrombosis (DVT) for whom anticoagulation is contraindicated or needs to be stopped at the time of labor. Injection of chemical into the gestational sac can be performed under ultrasonography (USG) guidance to treat ectopic pregnancy. Percutaneous or transvaginal drainage of a collection can be done by ultrasound or computed tomography (CT) guidance for puerperal sepsis. Percutaneous nephrostomy (PCN) is performed for obstructive ureterolithiasis in case of urosepsis or significant stone burden. Sonography should be used for the guidance of interventional radiology (IR) procedures whenever possible. Fluoroscopy must be used only if necessary, giving special attention to radiation-sparing maneuvers.

How to cite this article: Kulkarni S, Shetty NS, Gupta A, Rao S, Bansal H. Interventional Radiology in Obstetric Emergencies. Indian J Crit Care Med 2021;25(Suppl 3):S273-S278.

Keywords: Interventional radiologist; Interventional radiology; Obstetric emergencies; Obstetric hemorrhage embolization; Postpartum hemorrhage; Prophylactic balloon catheter insertion; Uterine artery embolization.