Uterine Artery Embolization for Management of Primary Postpartum Hemorrhage Associated with Placenta Accreta

Wang Zhi-wei; Li Xiao-guang; Pan Jie; Zhang Xiao-bo; Shi Hai-feng; Yang Ning; Jin* Zheng-yu

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Uterine Artery Embolization for Management of Primary Postpartum Hemorrhage Associated with Placenta Accreta

中国医学科学杂志（英文版） 2016年31卷第4期页码：228-232

Orginal Article | Updated：2024-04-10

- Uterine Artery Embolization for Management of Primary Postpartum Hemorrhage Associated with Placenta Accreta
- Affiliations：
  
  Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Author bio：
- Funds：
- DOI：
  中图分类号：
- 网络出版日期：2016-08-20，
  
  纸质出版日期：2016-08
- Accepted：
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Uterine Artery Embolization for Management of Primary Postpartum Hemorrhage Associated with Placenta Accreta[J]. 中国医学科学杂志（英文版）, 2016,31(4):228-232.

Wang Zhi-wei, Li Xiao-guang, Pan Jie, et al. Uterine Artery Embolization for Management of Primary Postpartum Hemorrhage Associated with Placenta Accreta[J]. Chinese medical sciences journal, 2016, 31(4): 228-232.
Uterine Artery Embolization for Management of Primary Postpartum Hemorrhage Associated with Placenta Accreta[J]. 中国医学科学杂志（英文版）, 2016,31(4):228-232. DOI：

Wang Zhi-wei, Li Xiao-guang, Pan Jie, et al. Uterine Artery Embolization for Management of Primary Postpartum Hemorrhage Associated with Placenta Accreta[J]. Chinese medical sciences journal, 2016, 31(4): 228-232. DOI：

摘要

Abstract

Objective

To evaluate the efficacy and safety of uterine artery embolization (UAE) in the management of primary postpartum hemorrhage associated with placenta accreta.

Methods

We retrospectively reviewed the medical records of patients with placenta accreta between January 2010 and August 2014. Totally 18 women (mean age 30.8±4.2 years) of primary massive postpartum hemorrhage with diagnosis of placenta accrete received treatment of UAE after delivery. Images of DSA and medical records were reviewed. Technical success was defined as control of bleeding after embolization. The complications

control of hemorrhage and recurrent bleeding of the placenta left inside the uterus were retrospectively collected for assessment.

Results

All patients underwent transcatheter embolization of bilateral uterine arteries. The technical success rate of embolization was 100%. Bleeding was controlled in 17 of 18 patients (94%) during follow-up period (median 18 months

3-31months) without further bleeding recurred. One patient with placenta percreta undertook an emergent hysterectomy along with surgical bladder repair after UAE because of persistent uterine bleeding. Eight patients had postembolization syndrome and no other complications occurred.

Conclusion

Uterine artery embolization is an effective and safe treatment for the management of primary postpartum massive hemorrhage associated with placenta accreta.

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references

Publications Committee , Society for Maternal-Fetal Medicine, Belfort MA. Placenta accreta. Am J Obstet Gynecol 2010 ; 203 : 430 - 9 .

Angstmann T , Gard G , Harrington T , et al. Surgical man- agement of placenta accreta: a cohort series and sugge-sted approach . Am J Obstet Gynecol. 2010 ; 202: 38 . e1 - 9 .

Choi SJ , Song SE , Jung KL , et al. Antepartum risk factors associated with peripartum cesarean hysterectomy in women with placenta previa. Am J Perinatol 2008 ; 25 : 37 - 41 .

Wu S , Kocherginsky M , Hibbard JU. Abnormal placentation: twenty-year analysis. Am J Obstet Gynecol 2005 ; 192 : 1458 - 61 .

Bauer ST , Bonanno C. Abnormal placentation. Semin Perinatol 2009 ; 33 : 88 - 96 .

Mehrabadi A , Hutcheon JA , Liu S , et al. Contribution of placenta accreta to the incidence of postpartum hemorr- hage and severe postpartum hemorrhage. Obstet Gynecol 2015 ; 125 : 814 - 21 .

Jin R , Guo Y , Chen Y. Risk factors associated with emergency peripartum hysterectomy. Chin Med J 2014 ; 127 : 900 - 4 .

Imudia AN , Awonuga AO , Dbouk T , et al. Incidence, trends, risk factors, indications for, and complications associated with cesarean hysterectomy: a 17-year experience from a single institution. Arch Gynecol Obstet 2009 ; 280 : 619 - 23 .

Khan M , Sachdeva P , Arora R , et al. Conservative management of morbidly adherent placenta—a case report and review of literature. Placenta 2013 ; 34 : 963 - 6 .

D'Souza DL , Kingdom JC , Amsalem H , et al . Conservative Management of Invasive Placenta Using Combined Proph- ylactic Internal Iliac Artery Balloon Occlusion and Imme- diate Postoperative Uterine Artery Embolization. Can Assoc Radiol J 2015 ; 66 : 179 - 84 .

Teixidor Viñas M , Chandraharan E , Moneta MV , et al. The role of interventional radiology in reducing haemorrhage and hysterectomy following caesarean section for morbidly adherent placenta. Clin Radiol 2014 ; 69 : e345 - 51 .

Lin K , Qin J , Xu K , et al. Methotrexate management for placenta accreta: a prospective study. Arch Gynecol Obstet 2015 ; 291 : 1259 - 64 .

Kong MC , To WW. Balloon tamponade for postpartum haemorrhage: case series and literature review. Hong Kong Med J 2013 ; 19 : 484 - 90 .

Salazar GM , Petrozza JC , Walker TG. Transcatheter endovascular techniques for management of obstetrical and gynecologic emergencies. Tech Vasc Interv Radiol 2009 ; 12 : 139 - 47 .

Ganguli S , Stecker MS , Pyne D , et al. Uterine artery embolization in the treatment of postpartum uterine hemorrhage. J Vasc Interv Radiol 2011 ; 22 : 169 - 76 .

Bros S , Chabrot P , Kastler A , et al. Recurrent bleeding within 24 hours after uterine artery embolization for severe postpartum hemorrhage: are there predictive factors? Cardiovasc Intervent Radiol 2012 ; 35 : 508 - 14 .

Katz MD , Sugay SB , Walker DK , et al. Beyond hemostasis: spectrum of gynecologic and obstetric indications for transcatheter embolization. Radiographics 2012 ; 32 : 1713 - 31 .

Jung HN , Shin SW , Choi SJ , et al. Uterine artery embolization for emergent management of postpartum hemorrhage associated with placenta accreta. Acta Radiol 2011 ; 52 : 638 - 42 .

Soyer P , Morel O , Fargeaudou Y , et al. Value of pelvic embolization in the management of severe postpartum hemorrhage due to placenta accreta, increta or percreta. Eur J Radiol 2010 ; 11 : 729 - 35 .

Diop AN , Chabrot P , Bertrand A , et al. Placenta accreta: management with uterine artery embolization in 17 cases. J Vasc Interv Radiol 2010 ; 21 : 644 - 8 .

Silver RM. Abnormal Placentation: Placenta Previa, Vasa Previa, and Placenta Accreta. Obstet Gynecol 2015 ; 126 : 654 - 68 .

Inoue S , Masuyama H , Hiramatsu Y. Efficacy of transar- terial embolisation in the management of post-partum haemorrhage and its impact on subsequent pregnancies. Aust N Z J Obstet Gynaecol 2014 ; 54 : 541 - 5 .

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