N-Butyl Cyanoacrylate Is Very Effective for Massive Haemorrhage during the Perinatal PeriodReportar como inadecuado




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Objective

The liquid embolic agent n-butyl cyanoacrylate NBCA is a tissue adhesive used as an immediate and permanent embolic agent when mixed with oil-based contrast medium. In this study, the preservation of fertility with TAE using NBCA for massive haemorrhage during pregnancy or the peripartum period and the utility of this therapy were investigated.

Methods

Cases from January 2005 to October 2010 in which TAE was performed for massive haemorrhage in pregnant women, particularly during the peripartum period, were investigated.

Results

TAE was performed in 27 pregnant women. The embolic agent used was GS only in five cases, NBCA only in 19 cases, and additional embolization with NBCA when the effect with GS was insufficient in three cases, one each of abruptio placentae, cervical pregnancy, and uterine atony.A comparison of mean blood loss when each embolic agent was used for haemostasis showed a significant difference between cases in which GS only was used and cases in which NBCA only was used. In a comparison of mean transfusion volume, a significant difference was seen between cases in which both GS and NBCA were used and cases in which NBCA only was used. In a postoperative follow-up survey, menses resumed in eight patients, including four patients who later became pregnant and three who delivered.

Conclusions

TAE with NBCA, which has an embolic effect unrelated to clotting dysfunction for massive haemorrhage during the peripartum period, is a minimally invasive and very effective treatment method for patients with severe DIC.



Autor: Suguru Igarashi , Shinichirou Izuchi, Yukihisa Ogawa, Misako Yoshimathu, Kenji Takizawa, Yasuo Nakajima, Mamoru Tanaka, Bunpei Is

Fuente: http://plos.srce.hr/



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