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Am J Perinatol 2010; 27(6): 455-461
DOI: 10.1055/s-0030-1247599
© Thieme Medical Publishers

Prophylactic Pelvic Artery Catheterization and Embolization in Women with Placenta Accreta: Can It Prevent Cesarean Hysterectomy?

Eyal Sivan1 , Maya Spira1 , Reuven Achiron1 , Uri Rimon2 , Gil Golan2 , Shali Mazaki-Tovi1 , Eyal Schiff1
  • 1Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel
  • 2Invasive Radiology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel
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Publikationsdatum:
29. Januar 2010 (online)

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ABSTRACT

We present the outcome of a relatively large cohort of women with suspected placenta accreta who underwent prophylactic pelvic artery catheterization prior to cesarean section. All pregnant women with suspected placenta accreta who delivered in one tertiary center were included in this retrospective study. All patients underwent an elective cesarean section with prophylactic pelvic artery catheterization of internal iliac arteries through femoral or brachial approach. Thirty women underwent prophylactic catheterization; placenta accreta was clinically confirmed in 25 (83.3%) cases. Embolization was performed in 23 cases (76.6%) and hysterectomy in 2 (8%). Median estimated amount of blood loss was 2000 mL (500 to 9000 mL). There were no major catheterization-related complications. Three women had a subsequent pregnancy and uncomplicated delivery by cesarean section. Prophylactic pelvic artery catheterization and embolization in women with placenta accreta is safe and effective in prevention of hysterectomy and should be considered in woman wishing to preserve fertility.

KEYWORDS

Balloon occlusion - catheterization - embolization - hysterectomy - placenta accreta

REFERENCES

  • 1 Committee on Obstetric Practice . ACOG committee opinion. Placenta accreta. Number 266, January 2002.  Int J Gynaecol Obstet. 2002;  77 77-78
    CrossrefPubMedGoogle Scholar
  • 2 Oyelese Y, Smulian J C. Placenta previa, placenta accreta, and vasa previa.  Obstet Gynecol. 2006;  107 927-941
    CrossrefPubMedGoogle Scholar
  • 3 Wu S, Kocherginsky M, Hibbard J U. Abnormal placentation: twenty-year analysis.  Am J Obstet Gynecol. 2005;  192 1458-1461
    CrossrefPubMedGoogle Scholar
  • 4 Gielchinsky Y, Rojansky N, Fasouliotis S J, Ezra Y. Placenta accreta—summary of 10 years: a survey of 310 cases.  Placenta. 2002;  23 210-214
    CrossrefPubMedGoogle Scholar
  • 5 Zaideh S M, Abu-Heija A T, El-Jallad M F. Placenta praevia and accreta: analysis of a two-year experience.  Gynecol Obstet Invest. 1998;  46 96-98
    CrossrefPubMedGoogle Scholar
  • 6 Miller D A, Chollet J A, Goodwin T M. Clinical risk factors for placenta previa-placenta accreta.  Am J Obstet Gynecol. 1997;  177 210-214
    CrossrefPubMedGoogle Scholar
  • 7 Bretelle F, Courbière B, Mazouni C et al.. Management of placenta accreta: morbidity and outcome.  Eur J Obstet Gynecol Reprod Biol. 2007;  133 34-39
    CrossrefPubMedGoogle Scholar
  • 8 Usta I M, Hobeika E M, Musa A A, Gabriel G E, Nassar A H. Placenta previa-accreta: risk factors and complications.  Am J Obstet Gynecol. 2005;  193(3 Pt 2) 1045-1049
    CrossrefPubMedGoogle Scholar
  • 9 Nisenblat V, Barak S, Griness O B, Degani S, Ohel G, Gonen R. Maternal complications associated with multiple cesarean deliveries.  Obstet Gynecol. 2006;  108 21-26
    CrossrefPubMedGoogle Scholar
  • 10 Clark S L, Koonings P P, Phelan J P. Placenta previa/accreta and prior cesarean section.  Obstet Gynecol. 1985;  66 89-92
    PubMedGoogle Scholar
  • 11 Practice Bulletin ACOG . ACOG Practice Bulletin: Clinical Management Guidelines for Obstetrician-Gynecologists Number 76, October 2006: postpartum hemorrhage.  Obstet Gynecol. 2006;  108 1039-1047
    CrossrefPubMedGoogle Scholar
  • 12 O'Brien J M, Barton J R, Donaldson E S, Donaldson E S. The management of placenta percreta: conservative and operative strategies.  Am J Obstet Gynecol. 1996;  175 1632-1638
    CrossrefPubMedGoogle Scholar
  • 13 Habek D, Becareviç R. Emergency peripartum hysterectomy in a tertiary obstetric center: 8-year evaluation.  Fetal Diagn Ther. 2007;  22 139-142
    CrossrefPubMedGoogle Scholar
  • 14 Kacmar J, Bhimani L, Boyd M, Shah-Hosseini R, Peipert J. Route of delivery as a risk factor for emergent peripartum hysterectomy: a case-control study.  Obstet Gynecol. 2003;  102 141-145
    CrossrefPubMedGoogle Scholar
  • 15 Glaze S, Ekwalanga P, Roberts G et al.. Peripartum hysterectomy: 1999 to 2006.  Obstet Gynecol. 2008;  111 732-738
    CrossrefPubMedGoogle Scholar
  • 16 Knight M. UKOSS . Peripartum hysterectomy in the UK: management and outcomes of the associated haemorrhage.  BJOG. 2007;  114 1380-1387
    CrossrefPubMedGoogle Scholar
  • 17 Kayem G, Davy C, Goffinet F, Thomas C, Clément D, Cabrol D. Conservative versus extirpative management in cases of placenta accreta.  Obstet Gynecol. 2004;  104 531-536
    CrossrefPubMedGoogle Scholar
  • 18 Timmermans S, van Hof A C, Duvekot J J. Conservative management of abnormally invasive placentation.  Obstet Gynecol Surv. 2007;  62 529-539
    CrossrefPubMedGoogle Scholar
  • 19 Hudon L, Belfort M A, Broome D R. Diagnosis and management of placenta percreta: a review.  Obstet Gynecol Surv. 1998;  53 509-517
    CrossrefPubMedGoogle Scholar
  • 20 Sumigama S, Itakura A, Ota T et al.. Placenta previa increta/percreta in Japan: a retrospective study of ultrasound findings, management and clinical course.  J Obstet Gynaecol Res. 2007;  33 606-611
    CrossrefPubMedGoogle Scholar
  • 21 Badawy S Z, Etman A, Singh M, Murphy K, Mayelli T, Philadelphia M. Uterine artery embolization: the role in obstetrics and gynecology.  Clin Imaging. 2001;  25 288-295
    CrossrefPubMedGoogle Scholar
  • 22 Hansch E, Chitkara U, McAlpine J, El-Sayed Y, Dake M D, Razavi M K. Pelvic arterial embolization for control of obstetric hemorrhage: a five-year experience.  Am J Obstet Gynecol. 1999;  180(6 Pt 1) 1454-1460
    CrossrefPubMedGoogle Scholar
  • 23 Chauleur C, Fanget C, Tourne G, Levy R, Larchez C, Seffert P. Serious primary post-partum hemorrhage, arterial embolization and future fertility: a retrospective study of 46 cases.  Hum Reprod. 2008;  23 1553-1559
    CrossrefPubMedGoogle Scholar
  • 24 Ornan D, White R, Pollak J, Tal M. Pelvic embolization for intractable postpartum hemorrhage: long-term follow-up and implications for fertility.  Obstet Gynecol. 2003;  102(5 Pt 1) 904-910
    CrossrefPubMedGoogle Scholar
  • 25 Salomon L J, deTayrac R, Castaigne-Meary V et al.. Fertility and pregnancy outcome following pelvic arterial embolization for severe post-partum haemorrhage. A cohort study.  Hum Reprod. 2003;  18 849-852
    CrossrefPubMedGoogle Scholar
  • 26 Alanis M, Hurst B S, Marshburn P B, Matthews M L. Conservative management of placenta increta with selective arterial embolization preserves future fertility and results in favorable outcome in subsequent pregnancies.  Fertil Steril. 2008;  86 1514.e3–7
    PubMedGoogle Scholar
  • 27 Warshak C R, Eskander R, Hull A D et al.. Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta.  Obstet Gynecol. 2006;  108(3 Pt 1) 573-581
    CrossrefPubMedGoogle Scholar
  • 28 Mazouni C, Gorincour G, Juhan V, Bretelle F. Placenta accreta: a review of current advances in prenatal diagnosis.  Placenta. 2007;  28 599-603
    CrossrefPubMedGoogle Scholar
  • 29 Comstock C H, Love Jr J J, Bronsteen R A et al.. Sonographic detection of placenta accreta in the second and third trimesters of pregnancy.  Am J Obstet Gynecol. 2004;  190 1135-1140
    CrossrefPubMedGoogle Scholar
  • 30 Ojala K, Perälä J, Kariniemi J, Ranta P, Raudaskoski T, Tekay A. Arterial embolization and prophylactic catheterization for the treatment for severe obstetric hemorrhage*.  Acta Obstet Gynecol Scand. 2005;  84 1075-1080
    CrossrefPubMedGoogle Scholar
  • 31 Tan C H, Tay K H, Sheah K et al.. Perioperative endovascular internal iliac artery occlusion balloon placement in management of placenta accreta.  AJR Am J Roentgenol. 2007;  189 1158-1163
    CrossrefPubMedGoogle Scholar
  • 32 Bodner L J, Nosher J L, Gribbin C, Siegel R L, Beale S, Scorza W. Balloon-assisted occlusion of the internal iliac arteries in patients with placenta accreta/percreta.  Cardiovasc Intervent Radiol. 2006;  29 354-361
    CrossrefPubMedGoogle Scholar
  • 33 Shrivastava V, Nageotte M, Major C, Haydon M, Wing D. Case-control comparison of cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters for placenta accreta.  Am J Obstet Gynecol. 2007;  197 402, e1–e5
    PubMedGoogle Scholar
  • 34 Shih J C, Liu K L, Shyu M K. Temporary balloon occlusion of the common iliac artery: new approach to bleeding control during cesarean hysterectomy for placenta percreta.  Am J Obstet Gynecol. 2005;  193 1756-1758
    CrossrefPubMedGoogle Scholar
  • 35 Sewell M F, Rosenblum D, Ehrenberg H. Arterial embolus during common iliac balloon catheterization at cesarean hysterectomy.  Obstet Gynecol. 2006;  108(3 Pt 2) 746-748
    CrossrefPubMedGoogle Scholar
  • 36 Kidney D D, Nguyen A M, Ahdoot D, Bickmore D, Deutsch L S, Majors C. Prophylactic perioperative hypogastric artery balloon occlusion in abnormal placentation.  AJR Am J Roentgenol. 2001;  176 1521-1524
    CrossrefPubMedGoogle Scholar
  • 37 Levine A B, Kuhlman K, Bonn J. Placenta accreta: comparison of cases managed with and without pelvic artery balloon catheters.  J Matern Fetal Med. 1999;  8 173-176
    CrossrefPubMedGoogle Scholar
  • 38 Weeks S M, Stroud T H, Sandhu J, Mauro M A, Jaques P F. Temporary balloon occlusion of the internal iliac arteries for control of hemorrhage during cesarean hysterectomy in a patient with placenta previa and placenta increta.  J Vasc Interv Radiol. 2000;  11 622-624
    CrossrefPubMedGoogle Scholar
  • 39 Dubois J, Garel L, Grignon A, Lemay M, Leduc L. Placenta percreta: balloon occlusion and embolization of the internal iliac arteries to reduce intraoperative blood losses.  Am J Obstet Gynecol. 1997;  176 723-726
    CrossrefPubMedGoogle Scholar
  • 40 Kuczkowski K M. Anesthesia for the repeat cesarean section in the parturient with abnormal placentation: what does an obstetrician need to know?.  Arch Gynecol Obstet. 2006;  273 319-321
    CrossrefPubMedGoogle Scholar

Prof. Eyal SivanM.D 

Department of Obstetrics and Gynecology, Sheba Medical Center

Tel-Hashomer, Israel 52621

eMail: eyal.sivan@gmail.com