Value of pelvic embolization in the management of severe postpartum hemorrhage due to placenta accreta, increta or percreta
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Soyer, Philippe
[1
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Morel, Olivier
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Hop Lariboisiere, AP HP, Dept Obstet & Gynecol, F-75475 Paris, FranceUniv Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, France
Morel, Olivier
[2
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Fargeaudou, Yann
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Univ Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, FranceUniv Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, France
Fargeaudou, Yann
[1
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Sirol, Marc
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Univ Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, FranceUniv Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, France
Sirol, Marc
[1
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Staub, Fabrice
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Univ Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, FranceUniv Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, France
Staub, Fabrice
[1
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Boudiaf, Mourad
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Univ Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, FranceUniv Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, France
Boudiaf, Mourad
[1
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Dahan, Henri
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Univ Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, FranceUniv Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, France
Dahan, Henri
[1
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Mebazaa, Alexandre
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Hop Lariboisiere, AP HP, Dept Anesthesiol & Intens Care Med, F-75475 Paris, FranceUniv Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, France
Mebazaa, Alexandre
[3
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Barranger, Emmanuel
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Hop Lariboisiere, AP HP, Dept Obstet & Gynecol, F-75475 Paris, FranceUniv Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, France
Barranger, Emmanuel
[2
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le Dref, Olivier
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Univ Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, FranceUniv Paris 07, Hop Lariboisiere, AP HP, Dept Abdominal & Intervent Imaging, F-75475 Paris 10, France
le Dref, Olivier
[1
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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
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.
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Taichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, TaiwanTaichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, Taiwan
Chou, MM
Hwang, JI
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Taichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, TaiwanTaichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, Taiwan
Hwang, JI
Tseng, JJ
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Taichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, TaiwanTaichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, Taiwan
Tseng, JJ
Shih, E
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Taichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, TaiwanTaichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, Taiwan
Shih, E
Ho, ESC
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Taichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, TaiwanTaichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, Taiwan
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Taichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, TaiwanTaichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, Taiwan
Chou, MM
Hwang, JI
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Taichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, TaiwanTaichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, Taiwan
Hwang, JI
Tseng, JJ
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Taichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, TaiwanTaichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, Taiwan
Tseng, JJ
Shih, E
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Taichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, TaiwanTaichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, Taiwan
Shih, E
Ho, ESC
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Taichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, TaiwanTaichung Vet Gen Hosp, Dept Obstet & Gynecol, Div Maternal Fetal Med, Taichung 407, Taiwan