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Case Reports
. 2017 Feb 24;12(2):261-264.
doi: 10.1016/j.radcr.2017.01.017. eCollection 2017 Jun.

Carbon dioxide angiography and arterial embolization could successfully control postpartum uterine hemorrhage for the patient with hypersensitivity to iodine compound

Sayaka Kawashita  1   2 , Masanori Kaneuchi  1 , Daisuke Nakayama  2 , Naoki Fuchi  1 , Yuko Murakami  1 , Kiyonori Miura  1 , Hideaki Masuzaki  1
Affiliations
Case Reports

Carbon dioxide angiography and arterial embolization could successfully control postpartum uterine hemorrhage for the patient with hypersensitivity to iodine compound

Sayaka Kawashita et al. Radiol Case Rep. .

Abstract

Transcatheter arterial embolization has become a common management option for intractable postpartum uterine hemorrhage. Iodinated contrast agents are commonly used for embolotherapy but cannot be used in patients with renal dysfunction or iodine allergy. A 37-year-old woman spontaneously delivered a healthy girl but developed severe postpartum uterine hemorrhage, probably due to placenta accrete. Contrast-enhanced computed tomography revealed extravasation of the iodinated contrast agent into the uterine cavity. The patient subsequently developed allergic reaction to this agent. After recovery from the allergic reaction with appropriate treatment, we performed carbon dioxide angiography and found that the extravasation originated from the right uterine artery. Embolization of the right internal iliac artery was performed, and hemostasis was verified. Based on this experience, we suggest carbon dioxide angiography and arterial embolization can be used for treating intractable postpartum hemorrhage in patients with iodinated contrast media allergy or renal dysfunction.

Keywords: Carbon dioxide; Iodine allergy; Postpartum hemorrhage.

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Figures

Fig. 1
Fig. 1
Contrast-enhanced computed tomography showed extravasation of the iodinated contrast agent into the uterine cavity (arrow).
Fig. 2
Fig. 2
(A) Carbon dioxide angiography showed contrast agent leakage from the right uterine artery (arrow) (before transcatheter arterial embolization). (B) Carbon dioxide angiography showed complete hemostasis (after transcatheter arterial embolization).
See this image and copyright information in PMC

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