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CardioVascular and Interventional Radiology

, Volume 42, Issue 2, pp 195–204 | Cite as

The Relationship Between Gelatin Sponge Preparation Methods and the Incidence of Intrauterine Synechia Following Uterine Artery Embolization for Postpartum Hemorrhage

  • Atsushi SaigaEmail author
  • Hajime Yokota
  • Takashi Higashide
  • Hazuki Takishima
  • Akiko Omoto
  • Yoshihiro Kubota
  • Takuro Horikoshi
  • Takashi Uno
Clinical Investigation Arterial Interventions
Part of the following topical collections:
  1. Arterial Interventions

Abstract

Purpose

To evaluate the relationship between gelatin sponge preparation methods and the incidence of intrauterine synechia following uterine artery embolization (UAE) for postpartum hemorrhage (PPH).

Materials and Methods

In a retrospective monocentric study, we used data from 20 consecutive UAE procedures (19 patients) for PPH, performed in 2007–2016, in which gelatin sponge had been used. The gelatin sponge was processed either into a slurry by pumping it back and forth about 10 times through two syringes connected to a three-way stopcock or into pledgets using a scalpel and small scissors to obtain pieces approximately 2 × 2 × 2 mm in size. Patient information was obtained from medical records, and the data were compared between patients treated with the slurry (n = 7) or pledgets (n = 13) forms. Due to the lack of follow-up data and hysterectomy after UAE, the sample size was 6 and 12 because 1 patient with 2 procedures was excluded.

Results

The rate of intrauterine synechia was significantly higher in the slurry group (5/6, 83.3%) than that in the pledgets group (0/12, 0%; P < 0.001). In contrast, there were no significant differences in population characteristics, such as the incidence of placenta accreta, non-placental diseases, and severity of shock (DIC score, shock index, or blood loss) between the groups.

Conclusions

Although non-randomization and small sample size were the two main limitations, our observations suggest that UAE using gelatin sponge slurry may be associated with a high incidence of intrauterine synechia compared to UAE using pledgets.

Keywords

Uterine arterial embolization Intrauterine synechia Postpartum hemorrhage Gelatin sponge preparation methods Pledgets Slurry 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

Consent for publication was obtained for every individual person’s data included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  1. 1.Department of RadiologyChiba University HospitalChiba CityJapan
  2. 2.Department of RadiologyJapanese Red Cross Narita HospitalNarita CityJapan
  3. 3.Department of Maternal-Fetal MedicineChiba University HospitalChiba CityJapan
  4. 4.Department of Diagnostic Radiology and Radiation OncologyChiba University Graduate School of MedicineChiba CityJapan

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