Oh Baby, Interventional Radiology Makes Childbirth Safer
C-sections and “Invasive” Placenta Condition Can Result in Excessive Bleeding and Be Life Threatening for Mothers
“Interventional radiology is making childbirth safer. Severe bleeding sometimes occurs either immediately after a C-section or up to several weeks after delivery. With embolization, interventional radiologists can block life-threatening bleeding immediately and effectively — from the inside out,” said
Similarly, interventional radiologists are making childbirth safer for women who suffer from a rare — but increasingly frequent — birth condition when a woman’s placenta (attached both to the wall of the uterus and to the baby’s umbilical cord) grows or “invades” into the uterine wall. “Minimally invasive interventional radiology treatments — that safely and immediately control bleeding and that may eliminate the need for a hysterectomy (or removal of the uterus) — are absolutely making childbirth safer for women,” said
C-section (or Cesarean section) is a common means of birthing today; it involves making a surgical incision in the mother’s uterus to deliver the baby. Most C-sections are done when a vaginal delivery would put either the baby’s or mother’s health at risk. The rate of C-sections in
Typically, treatment options for this bleeding (or postpartum hemorrhage) included conservative management (careful observation with supportive care until the bleeding resolves) or taking the mother to surgery to find the bleeding vessel and stop the bleeding. In some cases, surgical control of bleeding might even require a hysterectomy. More recently, interventional radiologists have added to the treatment options by being able to find and stop the bleeding with embolization, said Stecker.
Over two and a half years, 13 women (ages 28-44) who urgently needed embolization to control bleeding after a C-section were referred to the interventional radiology service at
Canadian researchers studied 14 women (ages 23-40) over a six-year period who were diagnosed with invasive placenta that was confirmed by a predelivery MRI. Interventional radiologists worked in a multidisciplinary team with obstetricians. The interventional radiologists guided balloon catheters into a woman’s left and right uterine artery (preoperative prophylactic insertion of bilateral internal iliac artery occlusion balloons) before delivery — to be ready to inflate (just like in angioplasty), if needed at delivery to block excessive blood flow, explained interventional radiologist
The retrospective study evaluated intraoperative blood loss, finding that obstetricians immediately see a dramatic decrease in bleeding once the balloons are inflated (allowing for easier surgical intervention). In examining hysterectomy rate, researchers found “considerable improvement,” with 75 percent of the women keeping their uteri (compared to previous statistics showing that 80 percent of women had hysterectomies), said Beecroft. He explained that interventional radiologists worked collaboratively with obstetricians/maternal fetal medicine specialists at Mount Sinai to provide a multidisciplinary approach for patients.
More information about women’s health issues and interventional radiology can be found online at www.SIRweb.org.
Abstract 173: “Endovascular Repair of Vascular Complications Following Cesarean Section,” C. Fan, D. Pyne,
Abstract 181: “Combined Prophylactic Internal Iliac Artery Balloon Occlusion and Uterine Artery Embolization in the Management of Invasive Placenta,”
About the Society of Interventional Radiology
Interventional radiologists are physicians who specialize in minimally invasive, targeted treatments. They offer the most in-depth knowledge of the least invasive treatments available coupled with diagnostic and clinical experience across all specialties. They use X-ray, MRI and other imaging to advance a catheter in the body, usually in an artery, to treat at the source of the disease internally. As the inventors of angioplasty and the catheter-delivered stent, which were first used in the legs to treat peripheral arterial disease, interventional radiologists pioneered minimally invasive modern medicine. Interventional oncology is a growing specialty area of interventional radiology.
Today many conditions that once required surgery can be treated less invasively by interventional radiologists. Interventional radiology treatments offer less risk, less pain and less recovery time compared to open surgery. Visit www.SIRweb.org.
An estimated 5,300 people are attending the Society of Interventional Radiology’s 34th Annual Scientific Meeting in
SOURCE Society of Interventional Radiology