An innovative technique to perform cesarean section in pregnant women with heart disease and risk of severe bleeding was recently applied by a multidisciplinary team from the Coimbra Hospital and University Center (CHUC).
In a statement, the CHUC pointed out that “this interventional radiology technique was performed for the first time in a pregnant woman with the fetus in the wombutilizing the unprecedented application of hemostatic balloons to the uterine arteries.”
The technique was applied to a 38-year-old pregnant woman who had had a mechanical valve prosthesis since she was 14 years old due to congenital heart disease.
This cardiac alteration, as well as other associated comorbidities (thrombophilia), gave her a very high thromboembolic risk during pregnancy, requiring close monitoring in terms of hypocoagulation, to avoid the formation of thrombi in the bloodstream that could be fatal”, he pointed. explained.
According to the CHUC, at 22 weeks of gestation there was “the formation of a valvular thrombus that led to admission to intensive care for cardiothoracic surgery” and, as a result of this complication, the pregnant woman suffered a stroke, “from which she managed to recover almost completely, having kept a close watch.”
the pregnancy, “very high risk”led to the preparation of a scheduled cesarean section at 35 weeks, which involved a multidisciplinary team with several specialties, namely Obstetrics and Gynecology, Anesthesia, Interventional Radiology, Immunohemotherapy, Cardiology and Pediatrics.
The CHUC pointed out that “the The greatest challenge was maintaining adequate hypocoagulation, without profuse bleeding. both during and after the cesarean section”, for which “two hemostatic balloons were placed percutaneously in the internal iliac arteries”.
Thus, it was possible to perform a local control of the blood flow that irrigates the uterustemporarily blocking it, without compromising the well-being of the child and maintaining the necessary hypocoagulation in the rest of the body“, he explained, adding that the procedure was carried out “with minimal blood loss” and that the mother and baby are doing well.
According to the CHUC, “the hemostatic balloon technique used by interventional radiology has been described for cases of placental accreta (placental retention) in which hysterectomy is performed shortly after cesarean section.”
The technique “had never been used in pregnant women before the baby was delivered“, he stressed.
Source: Observadora
