| アブストラクト | OBJECTIVE: To elucidate the demographics, clinical characteristics, and outcomes of patients with postpartum hemorrhage (PPH) who underwent transcatheter arterial embolization (TAE). METHODS: We conducted a retrospective observational study using the Japanese Diagnosis Procedure Combination inpatient database, which covers roughly 90% of all tertiary emergency hospitals in Japan, between April 2012 to March 2020. We identified patients with PPH who underwent TAE using the Japanese medical procedure status and code, and the device or drug code. We examined the patient characteristics, interventions administered, and clinical outcomes. RESULTS: Among 64 893 patients diagnosed with PPH, we identified 2705 (4.2%) patients with PPH who underwent TAE. The most common cause of PPH was uterine atony (68.7%), followed by disseminated intravascular coagulation after labor (30.0%) and placenta accreta spectrum disorders (23.4%). The proportion of patients who underwent repeat TAE and a hysterectomy was 64 (2.4%) and 188 (7.0%), respectively. Among hysterectomies (n = 188), 26 (13.8%) had the procedure performed before TAE, 73 (38.8%) underwent hysterectomy on the same day as TAE, and 89 (47.4%) had the procedure conducted after TAE. Of those who underwent a hysterectomy after TAE (n = 89), 33 (37%) were performed more than 1-week after initial TAE. Overall in-hospital mortality was 14/2705 (0.5%). CONCLUSION: Even if hemostasis is achieved through TAE, one must be mindful that a hysterectomy may become necessary more than 1 week after the procedure. These results could be helpful in clinical decision making and providing patients with additional treatment options for PPH that preserve patient fertility. |
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| ジャーナル名 | International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics |
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| Pubmed追加日 | 2024/11/18 |
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| 投稿者 | Kamijo, Kyosuke; Nakajima, Mikio; Shigemi, Daisuke; Kaszynski, Richard H; Ohbe, Hiroyuki; Goto, Tadahiro; Sasabuchi, Yusuke; Fushimi, Kiyohide; Matsui, Hiroki; Yasunaga, Hideo |
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| 組織名 | Department of Gynecology, Nagano Municipal Hospital, Nagano, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo,;Japan.;Department of Emergency and Critical Care Medicine, Tohoku University Hospital,;Miyagi, Japan.;TXP Medical Co. Ltd., Tokyo, Japan.;Department of Real-World Evidence, Graduate School of Medicine, The University of;Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39552524/ |
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