Effects of prophylactic uterine artery embolization on second‐trimester induced abortions in patients with placenta previa

Wang, Ning; Li, Xingmiao; Fei, Yilin; Liu, Yanmin; Lin, Jizhen; Jiang, Xingxing

doi:10.1002/ijgo.12638

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…Does prenatal bleeding reoccur after UAE? Wang et al [36] observed that patients with CSP who underwent curettage within 24 hours after UAE had a 5.0% risk of intraoperative bleeding. However, this risk increased to 19.4% for those with a treatment interval longer than 72 hours.…”

Section: Discussionmentioning

confidence: 99%

Clinical analysis of prophylactic uterine artery embolization combined with double balloon catheter for second-trimester pregnancy termination in cases of complete placenta previa: A retrospective study

Li,

Cheng,

Wen

et al. 2023

Medicine

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Complete placenta previa often causes significant bleeding in a short period during second-trimester pregnancy termination. This can destabilize the mother’s circulation, threatening her life. Furthermore, the condition is complicated by an immature cervix, making it a challenging clinical problem. The aim of this study was to investigate the effect of prophylactic uterine artery embolization (UAE) combined with double balloon catheter (DBC) deal with those cases. A total of 7 patients who underwent pregnancy termination in the second-trimester in Maternal and Child Health Hospital of Hubei Province between March 1st, 2021 and August 31st, 2023 were retrospectively analyzed in this study. All patients were diagnosed with complete placenta previa status and placenta accreta spectrum, and were treated with prophylactic UAE combined with DBC, and/or dilation and evacuation. All the patients received mifepristone, and 5 of them underwent medical termination with ethacridine lactate. Following prophylactic UAE combined with DBC, 6 patients underwent dilation and evacuation, which was monitored by ultrasound. And one patient experienced natural delivery of their fetus and placenta. Only one patient (patient 3) developed an intrapartum fever after prolonged duration of 18 hours from ethacridine to UAE and 56 hours from UAE to DBC. The amount of intrapartum hemorrhage ranged from 20 mL to 300 mL. The combined therapy of prophylactic UAE and DBC is a preferred option for patients with complete placenta previa undergoing second-trimester pregnancy termination. The use of dilation and evacuation may depend on the cervical condition, bleeding, or infection.

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Section: Discussionmentioning

confidence: 99%

Clinical analysis of prophylactic uterine artery embolization combined with double balloon catheter for second-trimester pregnancy termination in cases of complete placenta previa: A retrospective study

Li,

Cheng,

Wen

et al. 2023

Medicine

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“…In some cases, total or subtotal hysterectomy [5,6] is needed to stop those life-threatening bleeding. Mifepristone combined with ethacridine lactate/misoprostol is common method used in the second-trimester pregnancy termination in China especially for those CPP patients [7] , and those methods of drugs are effective and safe [8,9] . How to deal with the prenatal bleeding during induction for CPP patients with unfavorable cervix in the second trimester is the focus of current clinical work.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Study on the Clinical Effect of Uterine Artery Embolization Combined with Cervical Double Balloon for Patients with Complete Placenta Previa Undergoing Pregnancy Termination in the Second Trimester

Peng

et al. 2021

Preprint

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Background Pregnancy termination in the second trimester is a complex and delicate situation for patients with complete placenta previa (CPP), which has less been reported. The objective of this research was to investigate and evaluate the clinical effect of uterine artery embolization(UAE) combined with cervical double balloon(CDB) for patients with CPP. Methods We conducted a retrospective study based on a large medical center. The medical records of patients who were diagnosed with CPP and treated UAE combined with CDB for termination in the second trimester in our hospital from January 2017 and March 2021 were retrospectively reviewed. The clinical outcomes were analyzed.Results A total of 11 patients with CPP were included in this study. Prenatal diagnosis of CPP was realized by trans-vaginal ultrasound. The average age was 34.2 years old, and the gestational week was 21.6 weeks. Of the selected patients, 3 cases (3/11) had previous caesarean delivery, 5 cases were at older maternal age (≥35 years old), 10 cases underwent emergency UAE for prenatal bleeding equal or up to 400 mL and 1 case underwent prophylactic UAE for placenta percreta, and all cases underwent CDB to promote cervical ripening. It was worth noting that 5 cases (5/11) of selected patients underwent curettage to take out fetus and placenta. The uterus preservation was achieved in all 11 patients. The complications associated with conservative management included prenatal hemorrhaging (10/11), blood transfusion (5/11), fever (2/11), and septicemia (1/11). The mean dilation of cervix was from 0cm to 1.9cm, the length of cervix was from 3.5cm to 0.6cm and the Bishop scores were from 1.5 to 7.3 after using CDB, the changes of cervical conditions were statistically significant (p＜0.05). The levels of WBC and CRP were higher after termination with medicine+UAE+CDB and/or curettage. Conclusion The adjuvant therapy of UAE, CDB, and/curettage step by step is a preferred choice for patients with CPP who underwent pregnancy termination in the second trimester.

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“…Among these, it had been reported that bilateral uterine arteries embolization could significantly reduce the risk of cesarean section, hysterectomy, and transfusion for patients with placenta previa induction of labor, when the fetus is unlikely to survive. [12][13][14] However, few data are known about whether prophylactic uterine artery embolization (PUAE) during cesarean delivery could reduce the risk of hemorrhage, transfusion, hysterectomy, and postoperative hospitalization time, in termination of pregnancy of patients with single complete placenta previa. So we aimed to evaluate the effectiveness and safety of PUAE during cesarean delivery, for controlling blood loss in patients with complete placenta previa.…”

Section: Introductionmentioning

confidence: 99%

Prophylactic uterine artery embolization during cesarean delivery for management of hemorrhage in complete placenta previa: An observational study

Liu

Yang

et al. 2023

Medicine

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Complete placenta previa is a major cause of morbidity and mortality in pregnant women and fetuses. This study aimed to evaluate whether prophylactic uterine artery embolization (PUAE) could reduce bleeding in patients with complete placenta previa. We retrospectively analyzed patients with complete placenta previa admitted to Taixing People's Hospital for elective cesarean delivery between January 2019 and December 2020. The women were treated with PUAE (PUAE group, n = 20) or without (control group, control, n = 20). Risk factors for bleeding (age, gestational age, pregnancy times, delivery times, cesarean delivery times), intraoperative blood loss, hemoglobin difference before and after surgery, transfusions volume, hysterectomy cases, major maternal complication cases, neonatal birth weight, neonatal Apgar score in 1 minute, postoperative hospitalization time were compared between 2 groups. There were no significant differences on risk factors for bleeding, neonatal birth weight, neonatal Apgar score in 1 minute, postoperative hospitalization time between 2 groups. However, the intraoperative blood loss, hemoglobin before and after operation, transfusion volume in the PUAE group was significantly lower than the control. There was no case of hysterectomy or major maternal complications in both groups. PUAE during cesarean may be an effective and safe strategy to reduce intraoperative blood loss and transfusion volume for patients with complete placenta previa.

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Effects of prophylactic uterine artery embolization on second‐trimester induced abortions in patients with placenta previa

Abstract: ChiCTR-OPC-14005334.

Cited by 3 publications

References 21 publications

Clinical analysis of prophylactic uterine artery embolization combined with double balloon catheter for second-trimester pregnancy termination in cases of complete placenta previa: A retrospective study

Clinical analysis of prophylactic uterine artery embolization combined with double balloon catheter for second-trimester pregnancy termination in cases of complete placenta previa: A retrospective study

A Retrospective Study on the Clinical Effect of Uterine Artery Embolization Combined with Cervical Double Balloon for Patients with Complete Placenta Previa Undergoing Pregnancy Termination in the Second Trimester

Prophylactic uterine artery embolization during cesarean delivery for management of hemorrhage in complete placenta previa: An observational study

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