Prophylactic uterine artery embolization during cesarean delivery for placenta previa complicated by placenta accreta

• Published in: International journal of gynecology and obstetrics Vol. 149; no. 1; pp. 43 - 47
• Main Authors: Yuan, Qiang, Jin, Yong, Chen, Li, Ling, Li, Bai, Xu‐ming
• Format: Journal Article
• Language: English
• Published: United States 01.04.2020
• Subjects: Cesarean; Hemorrhage; Placenta accreta; Placenta previa; Radiologic interventional therapeutics; Uterine artery embolization; Placenta accreta; Radiologic interventional therapeutics; Placenta previa; Uterine artery embolization; Cesarean; Hemorrhage
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1002/ijgo.13072

Objective To evaluate the efficacy and safety of prophylactic uterine artery embolization (UAE) during cesarean delivery for women with placenta previa complicated by placenta accreta. Methods A retrospective analysis of women with placenta previa admitted to The Second Affiliated Hospital of Soochow University, Suzhou, China, for elective cesarean between February 2003 and July 2016. Postpartum estimated blood loss, blood transfusion, hysterectomy, disseminated intravascular coagulation (DIC) incidence, intensive care unit (ICU) duration, and postoperative stay were compared between control women who underwent cesarean delivery only and women who underwent prophylactic intraoperative UAE during cesarean. Results There were 28 and 26 women in the UAE and control group, respectively. There were no differences in hysterectomy incidence (P=0.291), or duration of ICU stay (P=0.085), or postoperative hospitalization (P=0.668) between the groups; however, the incidence of DIC was lower in the UAE group (P=0.035). Mean estimated blood loss (P=0.018) and blood transfusion (P=0.011) were also lower in the UAE group. No serious complications were associated with the endovascular procedures. Conclusion Prophylactic intraoperative UAE seemed to effectively reduce blood loss, need for blood transfusion, and incidence of DIC among women with placenta previa complicated by placenta accreta. Prophylactic intraoperative uterine artery embolization reduced blood loss, blood transfusion, and disseminated intravascular coagulation incidence among women with placenta previa complicated by placenta accreta.