Endovascular Balloon Occlusion in Obstetrical Hemorrhage

Abstract

Reduction in the maternal mortality ratio and in major obstetrical morbidity has long been a goal of the World Health Organization and other national and international groups. The loss of a mother during or after delivery exerts tremendous cost, not only financially but also psychosocially on her children, spouse and family, and her healthcare team. While maternal mortality has dramatically decreased in the last century in both developed nations and low-resource settings, over the last two decades, a disturbing rising trend in maternal mortality has been evident in the United States. Maternal mortality in developing nations, although improving, remains unacceptably high. Hemorrhage is the leading cause of maternal death world-wide and remains a leading cause even in high-resource settings. Novel approaches to timely, effective hemostatic control are needed to further reduce risk of death from hemorrhage. This chapter will review risk factors for bleeding in pregnancy, the leading causes of obstetrical hemorrhage, and the potential for use of endovascular balloon occlusion in this setting.