Previous uterine artery embolization increases the rate of repeat embolization in a subsequent pregnancy

Cho, Geum Joon; Shim, Jae-Yoon; Ouh, Yung Taek; Kim, Log Young; Lee, Tae Seon; Ahn, Ki Hoon; Hong, Soon Cheol; Oh, Min Jeong; Kim, Hai Joong; Lee, Pil Ryang

doi:10.1371/journal.pone.0185467

Cited by 8 publications

(3 citation statements)

References 25 publications

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“…13,[19][20][21][22][23] The study reported by Cho et al included 96 women and represents the largest study of subsequent pregnancy after UAE due to PPH. 32 A multivariate-adjusted analysis showed that UAE during a first delivery increased the rate of UAE at a second delivery (0.10% vs 5.9%; odds ratio, 25.56; 95% CI, 9.86-66.23), but the authors did not investigate the causes of PPH or the PAS rates; thus, the study did not satisfy our criteria for inclusion in the literature review.…”

Section: Discussionmentioning

confidence: 98%

<p>Obstetric Outcomes of Pregnancy After Uterine Artery Embolization</p>

Jitsumori¹,

Endo²,

Hara³

et al. 2020

IJWH

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Background: Uterine artery embolization (UAE) is used to treat severe postpartum hemorrhage (PPH). According to a few studies, UAE for PPH was associated with preterm birth, fetal growth restriction (FGR), and placenta accreta spectrum (PAS) in subsequent pregnancies. These previous studies, however, lacked controls, and to the best of our knowledge, no systematic literature reviews have been conducted thus far. We report the results of our retrospective case-control study of pregnancies after UAE at a single center and include a literature review to evaluate the risk of PAS in pregnancies after UAE. Methods: We retrospectively reviewed data from deliveries at our hospital between January 2012 and October 2017. We divided the delivery data into cases with previous UAEs performed for PPH (the post-UAE group) and those without UAEs (the non-UAE group, which included women without previous PPH). We defined PAS as cases in which hysterectomy was performed and pathological examination confirmed the diagnosis. Results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). Results: We used data from 3155 patients in this study, of whom 16 patients had undergone UAE (post-UAE group) and 3139 had not (non-UAE group). We found no differences between the groups in terms of frequency of preterm births (12.5% versus 14.2%, respectively; OR, 0.863; 95% CI, 0.218 to 3.414; P = 0.84) or FGR (6.2% versus 10.0%, respectively; OR, 0.602; 95% CI, 0.104 to 3.584; P = 0.61). However, cases of PAS were significantly more common in the post-UAE group (37.5%) than in the non-UAE group (1.2%; OR, 50.303; 95% CI, 17.38 to 145.592; P < 0.01). Conclusion: Our results suggest that previous UAE is a significant risk factor for PAS.

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Section: Discussionmentioning

confidence: 98%

<p>Obstetric Outcomes of Pregnancy After Uterine Artery Embolization</p>

Jitsumori¹,

Endo²,

Hara³

et al. 2020

IJWH

View full text Add to dashboard Cite

show abstract

“…A less invasive alternative to surgical methods is the UAE. The UAE has a success rate of 90% for adequate hemostasis . The UAE enables identification of the bleeding site easily and does not require laparatomy.…”

Section: Discussionmentioning

confidence: 99%

“…The UAE has a success rate of 90% for adequate hemostasis. 19 The UAE enables identification of the bleeding site easily and does not require laparatomy. One of the disadvantages is the absorption of embolization substance which may cause repeat embolizations and extravasations.…”

Section: Discussionmentioning

confidence: 99%