Methotrexate infusion followed by uterine artery embolisation for the management of placental adhesive disorders: a case series

Babaei, Mohammad Reza; Kian, Mojgan; Naderi, Zahra; Khodaverdi, Sepideh; Raoofi, Zahra; Javanmanesh, Forough; Mohseni, Iman; Nasiripour, Somayyeh; Farasatinasab, Maryam

doi:10.1016/j.crad.2019.01.006

Cited by 8 publications

(7 citation statements)

References 28 publications

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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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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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“…Babaei, et al (2019) 16 showed abnormal placenta implantation diagnosis was determined to be present in twenty-six different cases. Fourteen people were excluded because they underwent caesarean hysterectomy.…”

Section: Single-center Retrospective Study 40 Patientsmentioning

confidence: 99%

“…When risk factors are recognised and treated strategically at an earlier stage, there is a greater chance that the results for both the mother and the unborn child will be improved. Babaei, 2019 16…”

Section: Patientsmentioning

confidence: 99%

Uterus Preserving Treatment Modalities for Abnormal Invasive Placenta: A Systematic Review

Aromatika,

Nofriyadi,

Juliana

2023

JARMHS

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Background: When a focal accreta is identified, conservative intervention may be considered, such as preserving the uterus and placenta and then enduring methotrexate therapy or pelvic artery embolisation. In spite of this, surgical treatment remains the gold standard for the condition. Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up-to-date as it was possible to be. For this search approach, publications that came out between 2013 and 2023 were taken into account. Several different online reference sources, like Pubmed and SagePub, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Result: In the PubMed database, the results of our search brought up 401 articles, whereas the results of our search on SagePub brought up 289 articles. The results of the search conducted for the last year of 2013 yielded a total 43 articles for PubMed and 31 articles for SagePub. In the end, we compiled a total of 20 papers, 12 of which came from PubMed and 8 of which came from SagePub. We included seven research that met the criteria. Conclusion: Due to the intricacy of surgery, conservative management should be reserved for individuals who are interested in preserving their fertility as well as those who have major disease.

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“…MAP/PAS poses dramatic risk for massive obstetric hemorrhage along with serious complication such as consumption coagulopathy, multisystem organ failure, and maternal mortality. The surgical management choices may be considered according to available expertise, geographical and individual circumstances [3]. In addition, there is an increased risk for surgical complications such as injury to bladder, ureters, and bowel and the need for reoperation.…”

Section: Clinical Opinionmentioning

confidence: 99%

Fazari’s Sign in Ultrasound Scan of Morbid Adherent Placenta/Placenta Accreta Spectrum (MAP/PAS) and Fazari’s Triad during (MAP/PAS) Surgery

Fazari¹,

Hakim²

2020

OJOG

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Methotrexate infusion followed by uterine artery embolisation for the management of placental adhesive disorders: a case series

Cited by 8 publications

References 28 publications

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

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

Uterus Preserving Treatment Modalities for Abnormal Invasive Placenta: A Systematic Review

Fazari’s Sign in Ultrasound Scan of Morbid Adherent Placenta/Placenta Accreta Spectrum (MAP/PAS) and Fazari’s Triad during (MAP/PAS) Surgery

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