Uterine arterial embolization to assist induction of labor among patients with complete placenta previa

Peng, Qiaozhen; Zhang, Weishe

doi:10.1016/j.ijgo.2015.02.033

Cited by 8 publications

(7 citation statements)

References 16 publications

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“…UAE-assisted induction of labor was recently described as a feasible method for termination of pregnancy in women with CPP and was reported to have a high rate of successful vaginal delivery. 3,4 The experience at our center is similar; among 20 women treated with UAE, 16 women (80%) had a successful vaginal delivery (unpublished data).…”

Section: Discussionmentioning

confidence: 78%

“…UAE blocks the main placental blood supply, thereby reducing the incidence of peripartum hemorrhage and avoiding cesarean section in women at risk. In two separate case series, Peng and Zhang 3 and Huang et al 4 recommended UAEassisted induction of labor as a safe method of managing women with CPP because it was associated with a lower incidence of postpartum hemorrhage and fewer complications (such as gluteal muscle pain) without any increase in the duration of labor. Our experience with the successful use of UAE in 16 women supports this recommendation.…”

Section: Introductionmentioning

confidence: 99%

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Sepsis after uterine artery embolization-assisted termination of pregnancy with complete placenta previa: A case report

Wang

Huang

2017

J Int Med Res

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Uterine artery embolization (UAE)-assisted induction of labor is an alternative method of managing pregnant women with complete placenta previa (CPP). Sepsis secondary to UAE, although rare, is a serious complication. We herein present a case of severe sepsis following UAE-assisted termination of a pregnancy at 27 gestational weeks in a woman with CPP. The woman developed a high-grade fever and elevated inflammatory indices following UAE. She did not recover until the infected tissue was removed by emergency cesarean section. This case suggests that the increasing use of UAE for termination of pregnancy in women with CPP requires awareness regarding the possibility of serious sepsis associated with this procedure.

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Section: Discussionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Sepsis after uterine artery embolization-assisted termination of pregnancy with complete placenta previa: A case report

Wang

Huang

2017

J Int Med Res

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“…TOP assisted by UAE is recommend as an effective and safe method for addressing placenta previa. 8 Peng and Zhang 7 reported that compared with cesarean section, UAE-assisted induction of labor reduced the risk for hemorrhage without increasing the duration of labor. However, no reports have stated whether UAE is beneficial for second-trimester TOP.…”

Section: Discussionmentioning

confidence: 99%

“…6 UAE blocks the main blood supply of the placenta, thereby reducing bleeding during labor, and has been recommended as an effective method for TOP with CPP in recent years. 7,8 However, whether UAE is necessary for second-trimester TOP with CPP without accreta remains controversial. The incidence of placenta previa is overestimated because of the performance of routine, second-trimester ultrasonic scanning.…”

Section: Introductionmentioning

confidence: 99%

Prophylactic uterine artery embolization in second-trimester pregnancy termination with complete placenta previa

Wang

Pan

et al. 2018

J Int Med Res

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Objective This study was performed to assess whether prophylactic uterine artery embolization (UAE) is beneficial for second-trimester abortion with complete placenta previa (CPP). Methods Patients with CPP who underwent second-trimester pregnancy termination by labor induction with or without UAE from January 2010 to January 2018 were retrospectively reviewed. In total, 25 patients were eligible for analysis. The primary outcomes were the abortion success rate and bleeding volume, and the secondary outcomes were the induction-to-abortion time, length of hospital stay, and complications. Results CPP occurred in all 25 patients. Fifteen patients underwent prophylactic UAE (UAE group) and 10 did not (control group). Abortion was successful in 13 of 15 (86.7%) women in the UAE group and in 9 of 10 (90.0%) women in the control group. There was no significant difference in the bleeding volume or induction-to-abortion time between the two groups. The hospital stay was longer and pyrexia was more common in the UAE than control group. Conclusion Prophylactic UAE did not markedly improve the outcomes of second-trimester abortion in patients with CPP. Conversely, it may increase the risk of complications and prolong the hospital stay.

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“…And that would be a key element to save the lives of the patients when they complicated with Rh(D) negative blood type, in which case the homomorphous type blood resource is usually insufficient, meanwhile, placenta accreta would induce severe PPH. At present, there are so many obstetric hemostatic techniques, such as uterine artery embolization, [ 2 ] abdominal aorta and pelvic arteries balloon occlusion, [ 3 – 5 ] internal iliac artery ligation, [ 6 , 7 ] uterine cavity filling, [ 8 ] etc. However, abdominal aorta and pelvic arteries balloon occlusion are the only techniques which could be performed before CS in patients who want to keep the fetus and reserve fertility.…”

Section: Introductionmentioning

confidence: 99%

Rupture of multiple pseudoaneurysms as a rare complication of common iliac artery balloon occlusion in a patient with placenta accreta

Peng

Zhang

2018

Medicine

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Rationale:Placenta accreta is the main cause of severe obstetric postpartum hemorrhage (PPH) and hysterectomy. Several hemostatic techniques have been performed in patients with placenta accreta to prevent PPH and reserve fertility. Abdominal aorta and pelvic arteries balloon occlusion are the only techniques which could be performed before cesarean section (CS) in patients who want to keep the fetus and reserve fertility. However, abdominal aorta and pelvic arteries balloon occlusion might lead to severe complications such as formation and rupture of pseudoaneurysm, angiorrhexis, etc.Patient concerns:We report a case diagnosed with pernicious placenta previa (PPP) combined with Rh(D) negative blood type, who was performed with bilateral common iliac arteries (CIA) balloon occlusion during CS. However, on the first day after CS, the patient caught sudden left-side lumbago and backache accompanied with palpitation and shortness of breath.Diagnoses:Formation and rupture of multiple pseudoaneurysms in left CIA.Interventions:Covered stent was inserted into the proximal part of the left CIA and the ipsilateral internal iliac artery was embolized by coil to prevent endoleak.Outcomes:The patient recovered and discharged from hospital in stable condition without other complications 9 days after CS.Lessons:It is of paramount importance that obstetricians and radiologists correctly estimate the appropriate occlusion volume and pressure of pelvic arteries before CS to avoid formation and rupture of a pseudoaneurysm. And if the rupture of a pseudoaneurysm occurred, it should be quickly identified and treated with endovascular intervention.

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Uterine arterial embolization to assist induction of labor among patients with complete placenta previa

Abstract: UAE to assist induction of labor could be considered a feasible option for patients with CPP.

Cited by 8 publications

References 16 publications

Sepsis after uterine artery embolization-assisted termination of pregnancy with complete placenta previa: A case report

Sepsis after uterine artery embolization-assisted termination of pregnancy with complete placenta previa: A case report

Prophylactic uterine artery embolization in second-trimester pregnancy termination with complete placenta previa

Rupture of multiple pseudoaneurysms as a rare complication of common iliac artery balloon occlusion in a patient with placenta accreta

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