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

Eyal Sivan; Maya Spira; Reuven Achiron; Uri Rimon; Gil Golan; Shali Mazaki-Tovi; Eyal Schiff

doi:10.1055/s-0030-1247599

American Journal of Perinatology, Table of Contents

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

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

Abstract

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

Full Text

References

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Prof. Eyal SivanM.D

Department of Obstetrics and Gynecology, Sheba Medical Center

Tel-Hashomer, Israel 52621

Email: eyal.sivan@gmail.com