{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T16:57:55Z","timestamp":1784566675412,"version":"3.55.0"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,8,12]],"date-time":"2013-08-12T00:00:00Z","timestamp":1376265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2014,1]]},"abstract":"Abstract<\/jats:title>Aim<\/jats:title>Post\u2010partum hemorrhage (PPH<\/jats:styled-content>) is the leading cause of maternal mortality. Identification of the precise bleeding site is generally important to control hemorrhage, but such an approach has not been fully established in the context of PPH<\/jats:styled-content>. We postulated that visualization of bleeding sites could aid treatment decisions in the management of PPH<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>We conducted a prospective review of 26 patients who underwent dynamic computed tomography (CT<\/jats:styled-content>) for PPH<\/jats:styled-content>.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 17 cases presented with uterine bleeding, eight with vaginal hematomas, and one with hemoperitoneum. Overall, dynamic CT<\/jats:styled-content> identified contrast media extravasation in the arterial phase in 12 of 26 (46.2%) cases: the upper (n<\/jats:italic>\u2009=\u20094) and the lower uterine segment including the cervix (n<\/jats:italic>\u2009=\u20092), subfascial space (n<\/jats:italic>\u2009=\u20091) and vagina (n<\/jats:italic>\u2009=\u20095). Identification of precise arterial bleeding sites using CT<\/jats:styled-content> provided informative guidance about where to place balloons for intractable uterine bleeding, and how to manage hemoperitoneum and vaginal hematomas. In addition, dynamic CT<\/jats:styled-content> revealed the existence of a subtype of uterine atony, which is characterized by focal active arterial bleeding in the upper uterine segment. Furthermore, negative contrast extravasation extracted cases of PPH<\/jats:styled-content> that were well controlled without the need for surgical or radiological intervention. No patient required emergency hysterectomy to control PPH<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Dynamic CT<\/jats:styled-content> has potential clinical utility in treatment decision\u2010making for PPH<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.12123","type":"journal-article","created":{"date-parts":[[2013,8,13]],"date-time":"2013-08-13T04:41:36Z","timestamp":1376368896000},"page":"67-74","source":"Crossref","is-referenced-by-count":19,"title":["Treatment decision\u2010making for post\u2010partum hemorrhage using dynamic contrast\u2010enhanced computed tomography"],"prefix":"10.1111","volume":"40","author":[{"given":"Yosuke","family":"Kawamura","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics Kyoto University Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiji","family":"Kondoh","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Kyoto University Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junzo","family":"Hamanishi","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Kyoto University Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaoru","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Kyoto University Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Kyoto University Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiko","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Kyoto University Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akeo","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Kyoto University Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruta","family":"Mogami","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Kyoto University Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikuo","family":"Konishi","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Kyoto University Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,8,12]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"1039","article-title":"Clinical Management Guidelines for Obstetrician\u2010Gynecologists Number 76, October 2006: Postpartum hemorrhage","volume":"108","author":"ACOG Practice Bulletin","year":"2006","journal-title":"Obstet Gynecol"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2283020756"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.2290"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.09.3073"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2009.04.062"},{"key":"e_1_2_5_7_1","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1177\/000313481107700930","article-title":"The diagnostic accuracy of 64\u2010slice computed tomography in detecting clinically significant arterial bleeding after pelvic fractures","volume":"77","author":"Mohseni S","year":"2011","journal-title":"Am Surg"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-008-0907-z"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000253882"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0756.2012.02017.x"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-008-1140-5"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.01.051"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447\u20100756.2012.01879.x"},{"key":"e_1_2_5_14_1","first-page":"194","volume-title":"Textbook of Postpartum Hemorrhage. 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