The role of the interventional radiologist in the management of postpartum haemorrhage

Author(s): Dr Shyamal Patel, Dr Liisa Chang, Dr Lakshmi Ratnam

Hospital: St George's University Hospitals NHS Trust

Reference: RAD Magazine, 47, 549, 23-24


IntervePrimary PPH occurs within 24 hours of delivery and is defined as >500ml of blood loss after vaginal delivery or >1,000ml after caesarean section, with major PPH considered as haemorrhage >1,500ml. Since the assessment of volume can be inaccurate, the presence of haemodynamic instability is most useful in guiding management.

PPH typically originates from one of the following four processes:
• tone – uterine atony is the most common cause (approximately 80% of cases);
• trauma – genital tract trauma/laceration; • tissue – retained products/placental tissue;
• thrombin – clotting disorders can cause PPH in isolation or in combination with any of the above.

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