Placenta Accreta: Management with Uterine Artery Embolization in 17 Cases

Diop, Abdoulaye Ndoye; Chabrot, P.; Bertrand, A.; Constantin, Jean Michel; Cassagnes, L.; Storme, B.; Gallot, Denis; Boyer, L.

doi:10.1016/j.jvir.2010.01.015

Cited by 68 publications

(60 citation statements)

References 20 publications

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“…Pregnancy after IVR has been reported to be associated with an increased risk of placenta accreta. 3,5) Our results are consistent with these reports. As for placenta accreta, IVR may induce inflammatory changes in the uterus in addition to the ischemic damage caused by reduced blood flow.…”

Section: Discussionsupporting

confidence: 93%

“…7) Recently, it was reported that the risk for placenta accreta in the next pregnancy increases. [3][4][5] IVR might be involved in the local infectious response in addition to vascular remodeling due to ischemia in the area of the uterus treated by IVR. SMCs in human arteries contain at least three MHC isoforms: SM1, SM2, and SMemb.…”

Section: Discussionmentioning

confidence: 99%

“…3) Some studies have reported that pregnancy after IVR may be associated with an increased risk of placenta accreta, 4,5) and that this process might involve local infectious responses as well as vascular remodeling due to ischemia in the region of the uterus treated by IVR. Another study reported that the composition of myosin heavy chain (MHC) isoforms in smooth muscle cells (SMCs) changes with the proliferation and de-differentiation of SMCs during angiogenesis.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Novel histological findings in the uterus after interventional radiology: a case report of placenta accreta

Yamamoto

Suzuki

et al. 2017

Hypertens Res Pregnancy

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Novel histological findings in the uterus after interventional radiology: a case report of placenta accreta

Yamamoto

Suzuki

et al. 2017

Hypertens Res Pregnancy

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“…Due to the good collateralization, additional embolization is recommended despite the success rate of balloon occlusion of 40 % in some cases [20]. However, prior embolization that is reported to have a success rate of more than 95 % in some cases [26,27] is accompanied by greater radiation exposure for the patient than temporary occlusion. Alternatively, ligature of the internal iliac artery can be considered.…”

mentioning

confidence: 99%

Intraoperative Intermittent Blocking of the Common Iliac Arteries in Cases of Placenta Percreta without the Use of Fluoroscopy

Heinze

Filsinger

Kastenholz

et al. 2016

Fortschr Röntgenstr

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Background: The number of patients with placenta accreta, percreta and increta is increasing. The morbidity and mortality are higher mostly due to hemorrhage. Therefore, new methods to reduce the risk of severe bleeding are necessary. Methods: Three patients were treated in collaboration by obstetricians, urologists, anesthesiologists, and radiologists. An MRI of the pelvis was performed and the diameters and lengths of the iliac arteries were measured to?avoid fluoroscopy during the preoperative placement of catheter balloons into the iliac arteries. During the operational procedure the balloons were inflated and deflated depending on the operative site and the occurrence of bleeding. Results: In comparison to the literature, severe bleeding was clearly reduced. No complications of the intervention were observed. Conclusion: The presented method to reduce severe bleeding might represent significant progress in the management of abnormal placenta implantation. Nevertheless, further controlled studies are needed in order to establish evidence-based recommendations. Key Points: ??Reduction of perioperative hemorrhage in cases of placenta accreta, percreta, and increta. ??A preinterventional MRI of the pelvis allows measurement of the illiac arteries so that the fetus is not exposed to radiation. ??The short occlusion time (under the nominal pressure of the balloon) of the common iliac arteries reduced interventional complications. Citation Format: ??Heinze S, Filsinger B, Kastenholz G et?al. Intraoperative Intermittent Blocking of the Common Iliac Arteries in Cases of Placenta Percreta without the Use of Fluoroscopy. Fortschr R?ntgenstr 2016; 188: 1151???1155

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“…Among women in the preventive group, one underwent hysterectomy due to hemorrhage 2 days after the procedure, and another was submitted to a second embolization, due to hemorrhage 2 months after the initial embolization. Blood losses were significantly smaller in the preventive group, but later one case of intrauterine synechia and one case of amenorrhea were recorded (7) . Nevertheless, not all authors agreed on the benefits of the method.…”

Section: Introductionmentioning

confidence: 83%

Interventional radiology to treat severe obstetric hemorrhages

Lippi

2011

Einstein (São Paulo)

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The author discusses the recent role of interventional radiology to prevent postpartum hemorrhagic complications that represent an important cause of maternal morbidity and mortality all over the world. Hence, hemorrhage control is mandatory. Traditional management and recent minimally invasive radiological procedures by means of inserting occluding balloons into appropriate vessels are analyzed. It is advisable that maternity hospitals have protocols for the management of obstetric hemorrhage by means of interventional radiology, either in their own departments or in association with other large healthcare units that may have proper equipment and trained staff. However, the evidence related to its efficacy is limited to series of cases analyzed in tertiary centers. This is a promising technique that may be applied to severe obstetric hemorrhages and may bring beneficial results in the majority of cases.Keywords: Postpartum, hemorrhage; Placenta; Placenta accreta; Radiology, Interventional RESUMOO autor discute o recente papel da radiologia intervencionista para prevenir complicações hemorrágicas pós-parto que constituem importante causa de morbidade e mortalidade maternas em todo o mundo, o que torna mandatório o controle da hemorragia. São analisadas as condutas clássicas e as técnicas atuais minimamente invasivas de radiologia intervencionista por meio da inserção de balões em vasos apropriados. É aconselhável que as maternidades possuam protocolos para a aplicação dessas técnicas, quer seja nas ações internas ou em associação com outras instituições de maior porte que disponham dos equipamentos e pessoal especializado. Contudo, as evidências relativas à sua eficácia são ainda limitadas a séries de casos, analisadas em centros terciários. Essa é uma técnica promissora cuja aplicação nos casos de hemorragias obstétricas graves traz resultados benéficos na maioria das vezes.

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Placenta Accreta: Management with Uterine Artery Embolization in 17 Cases

Cited by 68 publications

References 20 publications

Novel histological findings in the uterus after interventional radiology: a case report of placenta accreta

Novel histological findings in the uterus after interventional radiology: a case report of placenta accreta

Intraoperative Intermittent Blocking of the Common Iliac Arteries in Cases of Placenta Percreta without the Use of Fluoroscopy

Interventional radiology to treat severe obstetric hemorrhages

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