Ep. 393 Peripartum and Postpartum Hemorrhage with Dr. Dan Sheeran

Ep. 393 Peripartum and Postpartum Hemorrhage with Dr. Dan Sheeran

In this episode of the BackTable Podcast, host Dr. Ally Baheti and Dr. Daniel Sheeran discuss the management and treatment of peripartum and postpartum hemorrhage. Dr. Sheeran highlights the importance of imaging-based diagnostics, particularly with MRI, to identify the source of bleeding and guide therapy. He also explains the need to employ a variety of techniques tailored towards each individual situation, which may involve utilizing different types of catheters, occlusion balloons, and embolics. He underlines the necessity to balance effective treatment with the preservation of uterine health, especially for women who may wish to have future pregnancies. In severe cases, he mentions the possibility of temporary aortic occlusion. As a final point, Dr. Sheeran argues that Interventional Radiology can play a crucial role in managing these types of cases and potentially avoiding hysterectomies. --- CHECK OUT OUR SPONSOR Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:00 - Breakdown of Types of Hemorrhages 03:26 - Understanding Peripartum Hemorrhage 04:05 - Discussion on Postpartum Hemorrhage 07:52 - Technical Details of Balloon Occlusion 08:00 - Procedure for Peripartum Hemorrhage 21:15 - Blood Loss in Medical Procedures 22:48 - Uterine Artery Embolization 27:10 - Post-Procedure Follow Up and Fertility Concerns 30:05 - Technical Points for Newcomers in the Field 36:12 - The Role of REBOA in Treating Postpartum Hemorrhage --- RESOURCES The role of interventional radiology in the management of abnormally invasive placenta: a systematic review of current evidences: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276355/ Magnetic Resonance Imaging of Placenta Accreta Spectrum: A Step-by-Step Approach: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817633/ Role of interventional radiology in placenta accreta spectrum (PAS) disorders: https://www.sciencedirect.com/science/article/pii/S1521693421000146 Perioperative temporary occlusion of the internal iliac arteries as prophylaxis in cesarean section at risk of hemorrhage in placenta accreta: https://pubmed.ncbi.nlm.nih.gov/21598085/ Aberrant Ovarian and Uterine Feeding from the Renal Artery at the End of Gestation: Two Cases: https://www.jvir.org/article/S1051-0443(10)00863-8/fulltext Uterine Fundal Blood Supply from an Aberrant Left Ovarian Artery Originating from the Inferior Mesenteric Artery: Implications for Uterine Artery Embolization: https://www.jvir.org/article/S1051-0443(10)00191-0/fulltext Pregnancy success and outcomes after uterine fibroid embolization: updated review of published literature: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6948071/ Uterine artery embolisation: fertility, adenomyosis and size – what is the evidence?: https://cvirendovasc.springeropen.com/articles/10.1186/s42155-023-00353-2 Use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Proximal Aortic Control in Patients With Severe Hemorrhage and Arrest: https://pubmed.ncbi.nlm.nih.gov/28973104/ Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): https://prytimemedical.com/clinical/reboa/ Resuscitative endovascular balloon occlusion of the aorta (REBOA) for life-threatening postpartum hemorrhage: A nationwide observational study in Japan: https://pubmed.ncbi.nlm.nih.gov/35444149/ Efficacy of resuscitative endovascular balloon occlusion of the aorta (REBOA) for hemorrhage control in patients with abnormally invasive placenta: a historical cohort study: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05649-8 An elective hybrid suite approach to the management of placenta accreta-associated postpartum hemorrhage (PPH): https://www.jvir.org/article/S1051-0443(13)00311-4/fulltext The role of interventional radiology in primary postpartum hemorrhage: https://www.jstage.jst.go.jp/article/jsshp/4/2/4_HRP2015-016/_article

Episoder(617)

Ep. 64 Bridging to Transplant for HCC with Dr. Jennifer Berumen and Dr. Isabel Newton

Ep. 64 Bridging to Transplant for HCC with Dr. Jennifer Berumen and Dr. Isabel Newton

Transplant Surgeon Dr. Jennifer Berumen and Interventional Radiologist Dr. Isabel Newton discuss the treatment of HCC and the importance of multi-specialty collaboration in bridging these patients to successful liver transplantation. Special discussion was given around this HCC consortium article in Annals of Surgery: https://pubmed.ncbi.nlm.nih.gov/30870180/

21 Mai 202050min

Ep. 63 IR Identity and Turf Wars with Dr. Eric Keller

Ep. 63 IR Identity and Turf Wars with Dr. Eric Keller

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/48hidj Dr. Eric J. Keller from Stanford Medicine Department of Radiology provides insight from his studies on the IR Identity, as well as his research on perceived turf wars between specialties.

11 Mai 202050min

Ep. 62 Protect Yourself Before You Wreck Yourself with Dr. Mina Makary

Ep. 62 Protect Yourself Before You Wreck Yourself with Dr. Mina Makary

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xsBt1Y Special guest Dr. Mina Makary from The Ohio State University Wexner Medical Center discusses the need for better awareness and protection from the serious harmful effects of chronic low dose radiation, which can sometimes require change in institutional culture. An extremely important occupational health issue!

27 Apr 202026min

Ep. 61 Physician Burnout with Dr. Jeff Chick and Dr. Jacob Bundy

Ep. 61 Physician Burnout with Dr. Jeff Chick and Dr. Jacob Bundy

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/nl8ZgW Dr. Jeffrey Chick and Dr. Jacob Bundy discuss the results of their recent study in April JVIR on rates and major contributors to Physician Burnout in IR, how they compare to other specialties, and how to prevent it in your own career.

13 Apr 202033min

Ep. 60 Building a Limb Salvage Program with Dr. Jihad Mustapha

Ep. 60 Building a Limb Salvage Program with Dr. Jihad Mustapha

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/08KW16 CLI fighters Sabeen Dhand and Jihad A. Mustapha discuss the essentials of building a successful Limb Salvage program, including the importance of a multidisciplinary approach, broadening skill sets such as pedal access, and meticulous patient follow up.

30 Mar 202049min

Special COVID-19 Weekend Update with UPenn IR Dr. Stephen Hunt

Special COVID-19 Weekend Update with UPenn IR Dr. Stephen Hunt

Dr. Stephen Hunt of Penn Medicine at University of Pennsylvania Health System discusses ways in which his IR practice has changed in the setting of the COVID 19 pandemic, including case selection and lessons learned from colleagues in Singapore and China.

28 Mar 202032min

Ep. 59 Endovascular Treatment of DVT with Dr. Dexter and Dr. Abramowitz

Ep. 59 Endovascular Treatment of DVT with Dr. Dexter and Dr. Abramowitz

Vascular Surgeons David Dexter and Steven Abramowitz discuss endovascular treatment of lower extremity DVT, including patient selection and risks and benefits of catheter-directed therapy (CDT), mechanical thrombectomy, and pharmaco-mechanical thrombolysis.

24 Mar 202059min

Ep. 58 Endovascular Treatment of PE with Dr. Venkat Tummala and Dr. Thomas Tu

Ep. 58 Endovascular Treatment of PE with Dr. Venkat Tummala and Dr. Thomas Tu

Interventional Cardiologist Thomas Tu, MD and Interventional Radiologist Venkat Tummala MD discuss their respective approach to the treatment of Pulmonary Embolism, including risk stratification, treatment options, and endovascular technique.

11 Mar 202045min

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