Intra-operative uterine artery embolization with caesarean delivery in an adjoining operating theatre and catheter lab (OT/CL) complex vs. conventional management in patients with abnormally invasive placenta: a retrospective case control study

Mohan, Bishav; Wander, Gurleen; Bansal, Rajeev; Mutti, Jasmine; Tandon, Pooja; Juneja, Sunil Kumar; Puri, Suman

doi:10.1080/01443615.2019.1621817

Cited by 8 publications

(5 citation statements)

References 16 publications

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“…Caesarean section is the main treatment method for PAS, and haemorrhage control during the operation is key for successful treatment. When traditional methods such as uterine cavity compression [10,11], uterine cavity water sac compression [12,13], uterine compression suturing [14,15], or uterine artery or internal iliac artery ligation [16,17] cannot control massive haemorrhage, hysterectomy is required [18,19]. However, hysterectomy results in physiological damage to the patient and imposes a mental burden on parturients and their families.…”

Section: Introductionmentioning

confidence: 99%

The application of prophylactic balloon occlusion of the internal iliac artery for the treatment of placenta accreta spectrum with placenta previa: a retrospective case-control study

Peng

Jiang

Cheng

et al. 2020

BMC Pregnancy Childbirth

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Background: Severe obstetric haemorrhage caused by placenta accreta spectrum (PAS) results in significant maternal morbidity and mortality. The effectiveness of prophylactic balloon occlusion of the internal iliac artery in PAS patients remains controversial. Therefore, we conducted a retrospective case-control study to investigate the clinical effectiveness of this treatment. Methods: The clinical data of 104 patients with PAS complicated with placenta previa who delivered by caesarean section between January 2016 and January 2019 were collected, and the patients were divided into two groups. The study group (48 cases) underwent internal iliac artery preset balloon occlusion before caesarean section and uterine artery embolisation according to the bleeding status after surgery, while the control group (56 cases) did not undergo internal iliac artery preset balloon occlusion before caesarean section. Results: The operation and hospitalisation times in the study group were longer than those in the control group. Additionally, the hysterectomy rate in the study group was significantly higher than that in the control group. No significant differences in blood loss, blood transfusion volume, urinary system injury, postoperative ICU transfer rate, or neonatal scores were identified between the groups. Among the patients without invasive placenta (placenta increta and percreta), blood loss was lower in the study group, and the caesarean hysterectomy rate did not significantly differ between the groups. Among the patients with invasive placenta, blood loss and the caesarean hysterectomy rate did not significantly differ between the groups. The risk of hysterectomy in the study group was related to invasive placenta penetration, a large area of placental invasion, or abnormal vascular filling. One patient in the study group had a thrombus in the left lower extremity artery.

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Section: Introductionmentioning

confidence: 99%

The application of prophylactic balloon occlusion of the internal iliac artery for the treatment of placenta accreta spectrum with placenta previa: a retrospective case-control study

Peng

Jiang

Cheng

et al. 2020

BMC Pregnancy Childbirth

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“…Recent studies showed that application of uterine artery embolization before delivery could effective to reduce hysterectomy frequency in patients with placenta previa. [ 22 – 24 ] In present study, there was no case of hysterectomy in both groups. However, there are still some complications of prophylactic uterine artery embolization during delivery, such as post-embolization syndrome, endometritis, peritonitis, fistula maternal and others.…”

Section: Discussionmentioning

confidence: 44%

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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“…Notably, conservative management was inconsistent among respondents 1 . Sixty‐one articles were retrieved from our CON‐PAS registry on conservative management using uterine artery embolization (23 studies), 27‐49 prophylactic balloon placement (15 studies), 2,50‐63 compression sutures (10 studies), 8,64‐72 leaving the placenta in situ (7 studies), 10,73‐78 and uterine wall excision and reconstruction (6 studies) 79‐84 . Despite the number of conducted studies (61 studies, 1979 patients), they have not yielded robust evidence‐based recommendations.…”

Section: Discussionmentioning

confidence: 99%

High‐intensity focused ultrasound in management of placenta accreta spectrum: A systematic review

Elazeem

Saad

Ahmed

et al. 2020

Intl J Gynecology & Obste

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Background: High-intensity focused ultrasound (HIFU) is a non-invasive procedure that has been studied in the management of placenta accreta spectrum (PAS). Objective: To appraise HIFU in the management of PAS and highlight the restrictions on converting uterus-preserving studies into evidence-based practice. Search strategy: A search on Scopus, Cochrane, PubMed and Web of Science was conducted from date of inception to January 2020. Selection criteria: Studies on using HIFU in the management of PAS were eligible. Review articles, conference papers, and case reports were excluded. Data collection: A standardized sheet was used to abstract data from eligible studies. CON-PAS registry was used to include studies on other conservative modalities. Results: Four studies were eligible (399 patients). Average residual placental volume was 61.74 cm 3 (6.01-339 cm 3). Treatment was successful in all patients. Normal menstruation recovered after 48.8 days (15-150 days). No major complications were encountered. Sixty-one studies were retrieved from the CON-PAS registry; uterine artery embolization (23 studies), balloon placement (15 studies), compression sutures (10 studies), placenta in situ (7 studies), and uterine resection (6 studies) were successful in 83.7%, 92.9%, 87.9%, 85.2%, and 79.3% of cases, respectively. Conclusions: HIFU may fit certain clinical situations in the management of PAS. A global research strategy is recommended to incorporate conservative approaches within a comprehensive management protocol.

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Intra-operative uterine artery embolization with caesarean delivery in an adjoining operating theatre and catheter lab (OT/CL) complex vs. conventional management in patients with abnormally invasive placenta: a retrospective case control study

Cited by 8 publications

References 16 publications

The application of prophylactic balloon occlusion of the internal iliac artery for the treatment of placenta accreta spectrum with placenta previa: a retrospective case-control study

The application of prophylactic balloon occlusion of the internal iliac artery for the treatment of placenta accreta spectrum with placenta previa: a retrospective case-control study

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

High‐intensity focused ultrasound in management of placenta accreta spectrum: A systematic review

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