Pregnancy outcome of uterine arterial embolization followed by selective hysteroscopic removal of a placental polyp

Abstract

Selective removal directed via hysteroscopy after reduction of blood supply by uterine arterial embolization provides a safe and effective method to minimize bleeding, and can preserve future fertility and successful uneventful pregnancies in the treatment of placental polyp with abundant blood flow.

Uterine preservation surgery for placental polyp

“…In order to preserve the uterus, transcervical hysteroscopic resection (TCR) was performed whenever possible. Despite reports related to the usefulness of uterine artery embolization (UAE), we did not perform UAE in our cases to avoid possible adverse effects on normal myometrium and ovarian function . With the speculation in mind that waiting a longer period until surgery may reduce intra‐polyp blood flow, the resection procedure was delayed as long as possible in cases showing imaging evidence of increased blood flow within the myometrium/placental polyp, in an attempt to reduce blood loss during surgery.…”

“…Recently, placental polyp removal surgery and uterine artery embolization have been proposed as surgical methods with the intention to preserve the uterus, and in some cases, a combination of these procedures has been chosen as a treatment method …”

“…Recently, placental polyp removal surgery 2 and uterine artery embolization have been proposed 3 as surgical methods with the intention to preserve the uterus, and in some cases, a combination of these procedures has been chosen as a treatment method. [4][5][6][7] Two-dimensional ultrasound and magnetic resonance imaging (MRI) have been used for diagnosis. Recently, there are some reports indicating that 3-D computed tomography angiography can be useful in diagnosing placental polyps and in determining a treatment plan.…”

Placental polyp: a diagnostic dilemma

“…20,21 Dyer I et al in their retrospective study concluded that after precise evaluation of neovascularization by computed tomographic angiography, hysteroscopic resection with preoperative uterine artery embolization is an effective minimally invasive procedure to conservatively treat placental polyp with prominent neovascularization. 22 Jimenez JS et al in their study concluded that diagnosticoperative ambulatory hysteroscopy is a suitable alternative to blind curettage in the management of retained trophoblastic tissue.…”

Placental polyp with prominent neovascularization

“…Placental polyp is a polypoid mass in the uterine cavity which is a fragment of placental tissue retained for an indefinite period after abortion or parturition (1)(2)(3). It is a potentially life-threatening condition that, in extreme cases, may require hysterectomy.…”