Oh baby, interventional radiology makes childbirth safer

Innovative, interventional radiology treatments are making childbirth safer for women who have C-sections that are complicated by massive bleeding and for those who suffer from the pregnancy condition of "invasive" placenta. The results of two studies detailing the effectiveness of minimally invasive treatments for pregnant women were released at the Society of Interventional Radiology's 34th Annual Scientific Meeting.

"Interventional radiology is making childbirth safer. Severe bleeding sometimes occurs either immediately after a C-section or up to several weeks after delivery. With embolization, interventional radiologists can block life-threatening bleeding immediately and effectively—from the inside out," said Michael S. Stecker, M.D., interventional radiologist at Brigham and Women's Hospital, Boston, Mass. Embolization is a well-established interventional radiology technique that blocks blood vessels, controlling hemorrhage. Interventional radiologists guide a catheter up a uterine artery using X-ray imaging. Once at the site of bleeding, clotting agents, such as tiny sponge-like gelfoam particles (the size of sand) or little metal coils, are released to block an injured vessel and stop the bleeding. "The women we treated tended to need fewer blood transfusions, had shorter hospital stays and did not have recurrence of the bleeding. All in all, our study shows that minimally invasive interventional radiology treatments can help control potentially life-threatening bleeding in women after C-sections with minimal complications," he added.

Similarly, interventional radiologists are making childbirth safer for women who suffer from a rare—but increasingly frequent—birth condition when a woman's placenta (attached both to the wall of the uterus and to the baby's umbilical cord) grows or "invades" into the uterine wall. "Minimally invasive interventional radiology treatments—that safely and immediately control bleeding and that may eliminate the need for a hysterectomy (or removal of the uterus)—are absolutely making childbirth safer for women," said John R. Kachura, M.D., interventional radiologist at Mount Sinai Hospital in Toronto, Ontario, Canada.

"These women are scared; this is a very serious and dangerous condition. Before interventional radiology treatment was available, the placenta couldn't be delivered and women would have to have a hysterectomy or in some cases died," he added. Canadian interventional radiologists controlled excessive bleeding in women with a combination of balloon catheters inserted into uterine arteries predelivery (that could be inflated to control bleeding, if necessary) and uterine artery embolization after delivery (if the placenta could not be delivered).

C-section (or Cesarean section) is a common means of birthing today; it involves making a surgical incision in the mother's uterus to deliver the baby. Most C-sections are done when a vaginal delivery would put either the baby's or mother's health at risk. The rate of C-sections in the United States has risen greatly over the past decade, and, in 2005, 30 percent of all births were by C-section, according to recent statistics. Although generally a very safe procedure, complications of C-sections happen rarely and may include injuries to the blood vessels that can cause prolonged and sometimes life-threatening bleeding in the mother.