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Transcatheter angiographic embolization for the control of massive pelvic hemorrhage due to gestational trophoblastic disease: A case series and review of the literature
  1. M. Moodley and
  2. J. Moodley
  1. Department of Obstetrics and Gynaecology and MRC/UN Pregnancy Hypertension Research Unit, Nelson R Mandela School of Medicine, University of Natal, Durban, South Africa
  1. Address correspondence and reprint requests to: M Moodley, Department of Obstetrics and Gynaecology, Nelson R Mandela School of Medicine, Private Bag 7, Congella, 4013 South Africa. E-mail: gynae{at}nu.ac.za

Abstract

Pelvic hemorrhage, either uterine or vaginal, secondary to gestational trophoblastic disease (GTD) can be catastrophic and sometimes fatal. Surgical intervention, however, such as resection of vaginal lesions or internal artery ligation are invasive and not without untoward events. Angiographic embolization is emerging as a practical, safe, effective, and less invasive technique with excellent results. This case series describes four patients with internal or external hemorrhage due to GTD. Angiography and embolization was performed using the modified Seldinger technique with gelfoam particles. The advantages of this method include outpatient procedure, conscious sedation, and minimal discomfort to the patient with excellent results. We conclude that angiographic embolization should be the method of choice in such circumstances and should form part of the therapeutic armamentarium of every interventional radiologist.

  • angiographic embolization
  • gestational trophoblastic disease
  • pelvic hemorrhage

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