Abnormal placentation and selective embolization of the uterine arteries

Objective: Abnormal placentation accounts for more than 50% of uterine artery embolization failure. The authors report their experience in this situation. Study design: Seven women presented with abnormal placentation. Uterine artery embolization was carried out in emergency or prophylactic control...

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Published in:European journal of obstetrics & gynecology and reproductive biology 2001-11, Vol.99 (1), p.47-52
Main Authors: Descargues, Gérôme, Douvrin, Françoise, Degré, Sophie, Lemoine, Jean Paul, Marpeau, Loı̈c, Clavier, Erick
Format: Article
Language:English
Subjects:
Adult
Arteries - surgery
Biological and medical sciences
Delivery. Postpartum. Lactation
Disorders
Embolization, Therapeutic - methods
Female
Genital system. Mammary gland
Gynecology. Andrology. Obstetrics
Humans
Medical sciences
Obstetric hemorrhage
Pelvic arterial embolization
Placenta accreta
Placenta Diseases - surgery
Placenta Diseases - therapy
Postpartum Hemorrhage - prevention & control
Pregnancy
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Uterine Hemorrhage - prevention & control
Uterus - surgery
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Summary:Objective: Abnormal placentation accounts for more than 50% of uterine artery embolization failure. The authors report their experience in this situation. Study design: Seven women presented with abnormal placentation. Uterine artery embolization was carried out in emergency or prophylactic control of postpartum bleeding. Results: In five patients, control of postpartum hemorrhage was obtained without hysterectomy. In two cases with no placental removal and prophylactic procedures, hysterectomy and blood transfusion were not necessary. The manual removal of the placenta was achieved secondarily, respectively on the 25th and the 12th day. Conclusions: The success rate of uterine artery embolization for postpartum bleeding appears to be lower with abnormal placentation. In none of the cases with the placenta present was it possible to leave the residual placenta in place. However, embolization may permit a safe waiting period and spontaneous migration of the placenta. When the diagnosis is made before delivery, prophylactic uterine artery embolization without placental removal should be considered to reduce blood transfusion and preserve fertility.
ISSN:0301-2115
1872-7654
DOI:10.1016/S0301-2115(01)00355-4