Value of pelvic embolization in the management of severe postpartum hemorrhage due to placenta accreta, increta or percreta

被引:54
作者
Soyer, Philippe [1 ]
Morel, Olivier [2 ]
Fargeaudou, Yann [1 ]
Sirol, Marc [1 ]
Staub, Fabrice [1 ]
Boudiaf, Mourad [1 ]
Dahan, Henri [1 ]
Mebazaa, Alexandre [3 ]
Barranger, Emmanuel [2 ]
le Dref, Olivier [1 ]
机构
[1] Univ Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, France
[2] Hop Lariboisiere, AP HP, Dept Obstet & Gynecol, F-75475 Paris, France
[3] Hop Lariboisiere, AP HP, Dept Anesthesiol & Intens Care Med, F-75475 Paris, France
关键词
Postpartum hemorrhage; Percutaneous transcatheter arterial embolization; Pelvic embolization; Abnormal placentation; Placenta percreta; ARTERIAL EMBOLIZATION; CONSERVATIVE MANAGEMENT; SELECTIVE EMBOLIZATION; ABNORMAL PLACENTATION; FERTILITY; HYSTERECTOMY; SURGERY; PREVIA;
D O I
10.1016/j.ejrad.2010.07.018
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Objectives: To evaluate the role, efficacy and safety of pelvic embolization in the management of severe postpartum hemorrhage in women with placenta accreta, increta or percreta. Methods: The clinical files and angiographic examinations of 12 consecutive women with placenta accreta (n = 4), increta (n = 2) or percreta (n = 6) who were treated with pelvic embolization because of severe primary (n = 10) or secondary (n = 2) postpartum hemorrhage were reviewed. Before embolization, four women had complete placental conservation, four had partial placental conservation, three had an extirpative approach and one had hysterectomy after failed partial conservative approach. Results: In 10 women, pelvic embolization was successful and stopped the bleeding, after one (n = 7) or two sessions (n = 3). Emergency hysterectomy was needed in two women with persistent bleeding after embolization, both with placenta percreta and bladder involvement first treated by extirpation. One case of regressive hematoma at the puncture site was the single complication of embolization. Conclusions: In women with severe postpartum hemorrhage due to placenta accreta, increta or percreta, pelvic embolization is effective for stopping the bleeding in most cases, thus allowing uterine conservation and future fertility. Further studies, however, should be done to evaluate the potential of pelvic embolization in women with placenta percreta with bladder involvement. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:729 / 735
页数:7
相关论文
共 41 条
  • [1] Conservative management of placenta increta with selective arterial embolization preserves future fertility and results in a favorable outcome in subsequent pregnancies
    Alanis, Mark
    Hurst, Bradley S.
    Marshburn, Paul B.
    Matthews, Michelle L.
    [J]. FERTILITY AND STERILITY, 2006, 86 (05) : 1514.e3 - 1514.e7
  • [2] Management of placenta accreta:: Morbidity and outcome
    Bretelle, Florence
    Courbiere, Blandine
    Mazouni, Chafika
    Agostini, Aubert
    Cravello, Ludovic
    Boubli, Leon
    Gamerre, Marc
    D'Ercole, Claude
    [J]. EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 2007, 133 (01) : 34 - 39
  • [3] Internal iliac artery embolization before hysterectomy for placenta accreta
    Chou, MM
    Hwang, JI
    Tseng, JJ
    Shih, E
    Ho, ESC
    [J]. JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2003, 14 (09) : 1195 - 1199
  • [4] Department of Reproductive Health and Research World Health Organization, 2004, WHO UNICEF UNFPA EST
  • [5] Abnormal placentation and selective embolization of the uterine arteries
    Descargues, G
    Douvrin, F
    Degré, S
    Lemoine, JP
    Marpeau, L
    Clavier, E
    [J]. EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 2001, 99 (01) : 47 - 52
  • [6] Is selective embolization of uterine arteries a safe alternative to hysterectomy in patients with postpartum hemorrhage?
    Deux, JF
    Bazot, M
    Le Blanche, AF
    Tassart, M
    Khalil, A
    Berkane, N
    Uzan, S
    Boudghène, F
    [J]. AMERICAN JOURNAL OF ROENTGENOLOGY, 2001, 177 (01) : 145 - 149
  • [7] Dinkel HP, 2003, J ENDOVASC THER, V10, P158, DOI 10.1583/1545-1550(2003)010<0158:PTOPPU>2.0.CO
  • [8] 2
  • [9] Placenta Accreta: Management with Uterine Artery Embolization in 17 Cases
    Diop, Abdoulaye N.
    Chabrot, Pascal
    Bertrand, Armelle
    Constantin, Jean M.
    Cassagnes, Lucie
    Storme, Brigitte
    Gallot, Denis
    Boyer, Louis
    [J]. JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2010, 21 (05) : 644 - 648
  • [10] Placenta percreta: urologic complication after successful conservative management by uterine arterial embolization: a case report
    Diop, Abdoulaye N.
    Bros, Sebastien
    Chabrot, Pascal
    Gallot, Denis
    Boyer, Louis
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2009, 201 (05) : E7 - E8