Transcatheter arterial embolisation for the management of obstetric haemorrhage associated with placental abnormality in 40 cases

Hwang, Sook Min; Jeon, Gyeong Sik; Kim, Man Deuk; Kim, Sang Heum; Lee, Jong Tae; Choi, Min Jeong

doi:10.1007/s00330-012-2612-1

Cited by 26 publications

(23 citation statements)

References 28 publications

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“…A recent Finnish retrospective study reported 89% success rate and 9% complication rate (local hematoma and iliac artery rupture) with this procedure [14]. Hwang et al [15] reported on 40 patients with intractable hemorrhage following abnormal placentation and noted a 93% clinical success of arterial embolization to stop bleeding. Only in three patients hysterectomy was required.…”

Section: Arterial Embolizationmentioning

confidence: 97%

Obstetric hemorrhage

Velde¹,

Varon

2015

Current Opinion in Anaesthesiology

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Postpartum hemorrhage is best managed by using a stepwise progressive approach. Manual and pharmacologic interventions are first-line treatments. Second-line treatments are used when bleeding continues; and hysterectomy is reserved for only the most extreme cases. Outcomes may be improved by thorough preparation, anticipating the risk of obstetric hemorrhage, and coordinating consultants for interventional procedures.

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Section: Arterial Embolizationmentioning

confidence: 97%

Obstetric hemorrhage

Velde¹,

Varon

2015

Current Opinion in Anaesthesiology

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“…However, this small study encompassed only patients without antenatal diagnosis of invasive placentation. 61 CONCLUSIONS Placenta accreta is increasing in incidence likely because of the increased rates of cesarean delivery. The antenatal diagnosis of placenta accreta is important to decrease maternal morbidity and mortality.…”

Section: Interventional Radiologymentioning

confidence: 98%

Ultrasound Imaging of Placenta Accreta With MR Correlation

Mar

Berggruen

Atueyi

et al. 2015

Ultrasound Quarterly

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Placenta accreta is abnormal placental adherence or invasion of the myometrium or extrauterine structures. It is increasing in incidence because of increasing number of cesarean sections and is one of the main causes of excessive postpartum hemorrhage. Recognition of this entity is crucial because improved outcomes have been shown when the antenatal diagnosis of placenta accreta is made. Ultrasound is the first-line tool; magnetic resonance imaging (MRI) is complementary. Ultrasound and MRI features and MRI protocols will be reviewed.

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“…Eleven articles reported 177 patients managed with embolisation of the pelvic arteries (Sivan et al 2010;Yu et al 2010;Park et al 2011;Soyer et al 2011;Hwang et al 2013;Meyer et al 2012;Li et al 2012;Bouvier et al 2012;Chung et al 2013;Diop et al 2010;Jung et al 2011): a secondary hysterectomy occurred in 20/177 (11.3%), a subsequent menstruation in 74/85 (87.1%) and a subsequent pregnancy in 3/10 (30%). All patients survived until the end of follow-up.…”

Section: Embolisation Of the Uterine Arteries (Table I)mentioning

confidence: 95%

Systematic review of uterus-preserving treatment modalities for abnormally invasive placenta

Mei

Zou

et al. 2015

Journal of Obstetrics and Gynaecology

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This is a systematic review for evaluating failure rates (secondary hysterectomy or maternal mortality) and success rates (subsequent menstruation or pregnancy) following radiological or conservative surgical interventions for abnormally invasive placenta (AIP). Twelve cohort studies and 8 case series or case reports were included. The cumulative outcomes showed success rates of 159/177 (89.8) for arterial embolisation, a secondary hysterectomy in 20/177 (11.3%), a subsequent menstruation in 74/85 (87.1%) and a subsequent pregnancy in 3/10 (30%). Artery occlusion balloon presented a success rate of 33/42 (78.6%), and a secondary hysterectomy presented that of 8/42 (19%). Uterus-preserving surgery showed a success rate of 48/76 (63.2), a secondary hysterectomy in 23/76 (30%), maternal mortality in 2/54 (3.7%), a subsequent menstruation in 20/37 (81.1%) and a subsequent pregnancy in 21/27 (77.8%). This review indicates that different uterine-sparing radiological and surgical techniques may be effective in managing AIP in select patients.

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Transcatheter arterial embolisation for the management of obstetric haemorrhage associated with placental abnormality in 40 cases

Abstract: PAE can be performed safely and effectively for patients with PPH and PA and can preserve the uterus in many patients.

Cited by 26 publications

References 28 publications

Obstetric hemorrhage

Obstetric hemorrhage

Ultrasound Imaging of Placenta Accreta With MR Correlation

Systematic review of uterus-preserving treatment modalities for abnormally invasive placenta

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