Abstract
IntroductionPostpartum haemorrhage is a major cause of maternal mortality. Although contrast-enhanced computed tomography (CE-CT) is useful to reveal arterial bleeding, its accuracy in postpartum haemorrhage is unclear. The aim of this study was to evaluate the accuracy of CE-CT scanning in detecting postpartum haemorrhage.MethodsThis was a retrospective observational study. We included patients with postpartum haemorrhage treated by emergency physicians in collaboration with obstetricians. We calculated the sensitivity, specificity, and positive and negative predictive values for CE-CT scanning to detect arterial bleeding.ResultsCE-CT scanning was performed in 52 patients, and 31 patients had extravasation. The sensitivity of CE-CT scanning to detect arterial extravasation was 100% (15/15), specificity was 28.6% (2/7), positive predictive value was 75% (15/20), and negative predictive value was 100% (2/2).ConclusionWe showed the sensitivity of CE-CT scanning to detect arterial extravasation in patients with postpartum haemorrhage to be 100%.
Highlights
Postpartum haemorrhage is a major cause of maternal mortality
Among the 81 patients with postpartum haemorrhage treated by emergency physicians in collaboration with obstetricians and gynaecologists during the study period, CE-computed tomography (CT) scanning was performed in 52 patients
In the group with extravasation on contrast-enhanced computed tomography (CE-CT) scanning and angiography, arterial embolization was performed in 19 patients (95.0%), surgery in 2 patients (10.0%), and postpartum balloon in 9 patients (45.0%)
Summary
Postpartum haemorrhage is a major cause of maternal mortality. Contrast-enhanced computed tomography (CE-CT) is useful to reveal arterial bleeding, its accuracy in postpartum haemorrhage is unclear. In the area of trauma, due to its minimal invasiveness and ease of use, contrast-enhanced computed tomography (CE-CT) is used to identify the source of bleeding [5]. The accuracy of CE-CT and angiography has been reported to be high and CE-CT has been shown to play an important role in Mitsuyama et al BMC Pregnancy and Childbirth (2022) 22:67 the detection of pelvic organ haemorrhage in the trauma setting [7]. There is little evidence on the use of CE-CT and angiography to identify the source of bleeding in postpartum haemorrhage
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