Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Enengl, S.
Diagnostics and possibilities of clinical management of residual placenta in cases with suspected arteriovenous malformation of the uterus or severe haemorrhage in the puerperium
[ Diplomarbeit ] Medical University of Graz; 2012. pp. 71
[OPEN ACCESS]
FullText
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Csapo Bence Daniel
- Haeusler Martin
- Altmetrics:
- Abstract:
- Background: In the postpartum period haemorrhage is one of the greatest risk factors for mother and child. The combination of residual placenta, which might require surgical intervention, and arteriovenous malformations (AVMs) of the uterus could be a main cause for severe haemorrhage postpartum. There are not many cases of uterine AVMs reported in literature, but it is possible, that this entity is more frequent than thought. Objective: The aim of this study was to find out more about the prevalence of uterine AVMs in cases with residual placenta and severe haemorrhage postpartum or in the puerperium. It is important to offer an adequate treatment to the patients to minimise the risk of maternal or fetal complications. Methods: A retrospective study has been carried out, investigating all cases of residual placenta at the Division of Obstetrics and Maternal Fetal Medicine at the Medical University of Graz from 2003-2011, with special attention for cases with severe bleeding complications after surgical interventions like dilatation & curettage (D&C). Results: The results show that uterine AVMs as cause for postpartum haemorrhage seem to be a speculative diagnosis, as no abnormal vascular connections were proved in the analysed cases. Some of the cases however did show symptoms which are without doubt compatible with AVM, so it stays a possible risk factor for bleeding complications in the postpartum period. Previous events, maternal risk factors and options for the management of blood loss could be explored and seem to correspond with current literature. Conclusion: Even though AVMs seem to be a rarity and often stay unobserved, it is important to be aware of the problem and the complications that might occur after residual placenta and surgical intervention.