Abnormal placentation and selective embolization of the uterine arteries

European Journal of Obstetrics, Gynecology, and Reproductive Biology
G DescarguesE Clavier

Abstract

Abnormal placentation accounts for more than 50% of uterine artery embolization failure. The authors report their experience in this situation. Seven women presented with abnormal placentation. Uterine artery embolization was carried out in emergency or prophylactic control of postpartum bleeding. In five patients, control of postpartum hemorrhage was obtained without hysterectomy. In two cases with no placental removal and prophylactic procedures, hysterectomy and blood transfusion were not necessary. The manual removal of the placenta was achieved secondarily, respectively on the 25th and the 12th day. The success rate of uterine artery embolization for postpartum bleeding appears to be lower with abnormal placentation. In none of the cases with the placenta present was it possible to leave the residual placenta in place. However, embolization may permit a safe waiting period and spontaneous migration of the placenta. When the diagnosis is made before delivery, prophylactic uterine artery embolization without placental removal should be considered to reduce blood transfusion and preserve fertility.

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Citations

Dec 1, 2008·Seminars in Interventional Radiology·Shellie C Josephs
May 22, 2009·AJR. American Journal of Roentgenology·Fred Burbank
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