Retrospective cohort study of prophylactic intraoperative uterine artery embolization for abnormally invasive placenta

Pan, Yongsheng; Zhou, Xin; Yang, Zhigang; Cui, Shudong; De, Wei; Sun, Lichao

doi:10.1002/ijgo.12090

Cited by 52 publications

(27 citation statements)

References 23 publications

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“…retrospective cohort study of 45 patients with AIP compared prophylactic artery uterine embolization to no embolization for women undergoing conservative management43 (level 2b evidence). No difference was observed in blood loss,M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPTIS-AIP Guideline for management of AIP 23 hysterectomy rates or incidence of massive transfusion.…”

mentioning

confidence: 99%

Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta

Collins

Alemdar

Beekhuizen

et al. 2019

American Journal of Obstetrics and Gynecology

248

228

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mentioning

confidence: 99%

Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta

Collins

Alemdar

Beekhuizen

et al. 2019

American Journal of Obstetrics and Gynecology

248

228

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“…Gelatin sponges constitute the majority of embolic substances 11,16,17 because they are absorbed within 2 weeks and the embolized vessels can then reconnect. 21 In cases where a large number of gelatin sponges are used and arterial blood flow to the uterus remains unaffected, polyvinyl alcohol particles may also be used.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic uterine artery embolization during cesarean delivery for placenta previa complicated by placenta accreta

Yuan

Jin

Chen

et al. 2019

Intl J Gynecology & Obste

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Objective To evaluate the efficacy and safety of prophylactic uterine artery embolization (UAE) during cesarean delivery for women with placenta previa complicated by placenta accreta. Methods A retrospective analysis of women with placenta previa admitted to The Second Affiliated Hospital of Soochow University, Suzhou, China, for elective cesarean between February 2003 and July 2016. Postpartum estimated blood loss, blood transfusion, hysterectomy, disseminated intravascular coagulation (DIC) incidence, intensive care unit (ICU) duration, and postoperative stay were compared between control women who underwent cesarean delivery only and women who underwent prophylactic intraoperative UAE during cesarean. Results There were 28 and 26 women in the UAE and control group, respectively. There were no differences in hysterectomy incidence (P=0.291), or duration of ICU stay (P=0.085), or postoperative hospitalization (P=0.668) between the groups; however, the incidence of DIC was lower in the UAE group (P=0.035). Mean estimated blood loss (P=0.018) and blood transfusion (P=0.011) were also lower in the UAE group. No serious complications were associated with the endovascular procedures. Conclusion Prophylactic intraoperative UAE seemed to effectively reduce blood loss, need for blood transfusion, and incidence of DIC among women with placenta previa complicated by placenta accreta.

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“…Techniques for UAE vary depending on the institutional protocols and published study. While an earlier study described cesarean delivery before endovascular intervention and catheterization of the uterine artery [ 34 ], in most instances, common femoral artery access and selective catheterization is obtained prior to cesarean delivery in order to expedite treatment [ 5 , 35 , 36 , 37 ]. In some select cases such as known fetal demise or non-viable fetus, UAE may even be performed prior to delivery of the fetus ( Figure 3 ).…”

Section: Endovascular Interventionsmentioning

confidence: 99%

Endovascular Interventions for the Morbidly Adherent Placenta

Kaufman

Tadros

2018

JCM

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Morbidly adherent placentas are a spectrum of abnormalities ranging from placental invasion of the myometrium to invasion past the myometrium and muscular layers into adjacent structures. This entity is becoming more prevalent recently with increased number of cesarean deliveries. Given the high risk of morbidity and mortality, this was traditionally treated with pre-term planned cesarean hysterectomy. However, recently, uterine preservation techniques have been implemented for those women wishing to preserve future fertility or their uterus. Early identification is crucial as studies have shown better outcomes for women treated at tertiary care facilities by a dedicated multidisciplinary team. Interventional radiologists are frequently included in the care of these patients as there are several different endovascular techniques which can be implemented to decrease morbidity in these patients both in conjunction with cesarean hysterectomy and in the setting of uterine preservation. This article will review the spectrum of morbidly adherent placentas, imaging, as well as the surgical and endovascular interventions implemented in the care of these complex patients.

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Retrospective cohort study of prophylactic intraoperative uterine artery embolization for abnormally invasive placenta

Abstract: Prophylactic intraoperative UAE was relatively safe and effective for reducing postpartum hemorrhage among patients with placenta accreta. The potential benefits could be lower among patients with placenta increta or percreta.

Cited by 52 publications

References 23 publications

Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta

Evidence-based guidelines for the management of abnormally invasive placenta: recommendations from the International Society for Abnormally Invasive Placenta

Prophylactic uterine artery embolization during cesarean delivery for placenta previa complicated by placenta accreta

Endovascular Interventions for the Morbidly Adherent Placenta

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