Document Detail

Percutaneous treatment of placenta percreta using coil embolization.
MedLine Citation:
PMID:  12751949     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To report the use of embolotherapy to avoid hysterectomy in rare placenta percreta. CASE REPORT: A pregnant 34-year-old woman (gravida 3, para 2) was admitted with premature rupture of membranes and vaginal bleeding in the 32nd week. Prenatal B-mode and Doppler ultrasound revealed marked hypervascularity of the placenta with disruption of the uterine-bladder interface consistent with placenta percreta. Since the patient insisted on uterine preservation, uterus and placenta were left in situ after caesarean section, which was followed by coaxial microcoil embolization of 6 pelvic arteries and postoperative methotrexate administration. Three months later, the patient had severe bleeding from the retained placenta, possibly under the influence of anticoagulation administered for pulmonary embolism. Emergent hysterectomy was performed. CONCLUSIONS: Coil embolization may avoid immediate hysterectomy and reduce peri-delivery blood loss in placenta percreta. However, retained placenta poses a serious risk, even after months, and secondary hysterectomy should be performed as an elective procedure after embolization.
Hans-Peter Dinkel; Peter Dürig; Peter Schnatterbeck; Jürgen Triller
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  10     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-05-19     Completed Date:  2003-10-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  158-62     Citation Subset:  IM    
Department of Diagnostic Radiology, University Hospital of Bern, Switzerland.
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MeSH Terms
Cesarean Section
Embolization, Therapeutic / methods*
Fetal Membranes, Premature Rupture
Placenta Accreta / radiography,  therapy*,  ultrasonography
Uterus / blood supply

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