BackTable / VI / Podcast / Episode #262

IR/OB Collaboration in Treating Postpartum Hemorrhage

with Dr. Roxane Rampersad and Dr. Anthony Shanks

On this episode, BackTable VI host Dr. Christopher Beck shares the mic with two Maternal Fetal Medicine (MFM) specialists, Drs. Roxane Rampersad at Washington University and Tony Shanks at Indiana University, to discuss cross-specialty management of postpartum hemorrhage (PPH) between OBGYN and interventional radiology (IR).

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Medtronic Concerto
IR/OB Collaboration in Treating Postpartum Hemorrhage with Dr. Roxane Rampersad and Dr. Anthony Shanks on the BackTable VI Podcast)
Ep 262 IR/OB Collaboration in Treating Postpartum Hemorrhage with Dr. Roxane Rampersad and Dr. Anthony Shanks
00:00 / 01:04

BackTable, LLC (Producer). (2022, November 17). Ep. 262 – IR/OB Collaboration in Treating Postpartum Hemorrhage [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. Roxane Rampersad discusses IR/OB Collaboration in Treating Postpartum Hemorrhage on the BackTable 262 Podcast

Dr. Roxane Rampersad

Dr. Roxane Rampersad is a professor and practicing OBGYN with Washington University School of Medicine in St. Louis.

Dr. Anthony Shanks discusses IR/OB Collaboration in Treating Postpartum Hemorrhage on the BackTable 262 Podcast

Dr. Anthony Shanks

Dr. Anthony Shanks is a professor of clinical obstetrics and gynecology with the Indiana University School of Medicine.

Dr. Christopher Beck discusses IR/OB Collaboration in Treating Postpartum Hemorrhage on the BackTable 262 Podcast

Dr. Christopher Beck

Dr. Chris Beck is a practicing interventional radiologist with Regional Radiology Group in New Orleans.

Show Notes

To set the stage, Drs. Rampersad and Shanks explain the definition of PPH based on the American College of Obstetricians and Gynecologists (ACOG) guidelines. They further describe the differences between early / acute versus late blood loss, in addition to the most common etiologies using the “Four T’s” pneumonic: tone, trauma, tissue, thrombin. Drs. Rampersad and Shanks then describe their approach to the workup and management of PPH. The group discusses topics such as uterine massage, oxytocin, hemabate / methergine, tamponade (e.g. Bakri balloon, the JADA System), embolization, and hysterectomy.

The physicians then describe the role of cross-specialty collaboration between OBGYN and IR, specifically in the management of PPH. When highlighting the role of IR, Dr. Beck describes how he counsels patients for uterine artery embolization (UAE), and he provides an anecdote regarding a repeat UAE. He also shares his perspective with utilization of gel foam versus coils. The group then transitions to describe diagnosis and management of placenta accreta spectrum (PAS), its association with PPH, and the role of radiology in this disease process.

Lastly, Drs. Rampersad and Shanks allude to what the future may hold for PPH, including more personalized medicine and potential technologies to prevent PAS. The group ends the episode by providing IR colleagues with insight to what may strengthen the collaboration between OBGYN and IR in order to provide optimal care for patients with PPH.

Resources

Silver RM, et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. 2006 Jun;107(6):1226-32. doi: 10.1097/01.AOG.0000219750.79480.84. PMID: 16738145.

Bienstock RM, Eke AC and Hueppchen NA; Postpartum Hemorrhage. New England Journal of Medicine 2021 Vol. 384 Issue 17 Pages 1635-1645. Accession Number: 33913640 DOI: 10.1056/NEJMra1513247.
https://www.nejm.org/doi/full/10.1056/NEJMra1513247

ACOG Postpartum Hemorrhage:
https://www.acog.org/en/clinical/clinical-guidance/practice-bulletin/articles/2017/10/postpartum-hemorrhage

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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