scholarly journals Clinical analysis of uterine artery embolization combined with double balloon catheter plus curettage for patients with placenta previa who underwent pregnancy termination and suffered antenatal massive hemorrhage in the 2nd trimester

Medicine ◽  
2019 ◽  
Vol 98 (4) ◽  
pp. e14266 ◽  
Author(s):  
Fei Tang ◽  
Shuguo Du ◽  
Yun Zhao ◽  
Guoqiang Sun ◽  
Ying Lin ◽  
...  
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Pregnancy Termination ◽  
Placenta Previa ◽  
Balloon Catheter ◽  
Clinical Analysis ◽  
Massive Hemorrhage ◽  
Artery Embolization ◽  
Double Balloon

scholarly journals A Retrospective Study on the Clinical Effect of Uterine Artery Embolization Combined with Cervical Double Balloon for Patients with Complete Placenta Previa Undergoing Pregnancy Termination in the Second Trimester

2021 ◽  
Author(s):  
Ruobing Li ◽  
Shuguo Du ◽  
Jing Peng ◽  
Xuan Zheng ◽  
Shiyao Wu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Clinical Effect ◽  
Pregnancy Termination ◽  
Placenta Previa ◽  
Cervical Ripening ◽  
Second Trimester ◽  
Artery Embolization ◽  
Double Balloon

Abstract Background Pregnancy termination in the second trimester is a complex and delicate situation for patients with complete placenta previa (CPP), which has less been reported. The objective of this research was to investigate and evaluate the clinical effect of uterine artery embolization(UAE) combined with cervical double balloon(CDB) for patients with CPP. Methods We conducted a retrospective study based on a large medical center. The medical records of patients who were diagnosed with CPP and treated UAE combined with CDB for termination in the second trimester in our hospital from January 2017 and March 2021 were retrospectively reviewed. The clinical outcomes were analyzed.Results A total of 11 patients with CPP were included in this study. Prenatal diagnosis of CPP was realized by trans-vaginal ultrasound. The average age was 34.2 years old, and the gestational week was 21.6 weeks. Of the selected patients, 3 cases (3/11) had previous caesarean delivery, 5 cases were at older maternal age (≥35 years old), 10 cases underwent emergency UAE for prenatal bleeding equal or up to 400 mL and 1 case underwent prophylactic UAE for placenta percreta, and all cases underwent CDB to promote cervical ripening. It was worth noting that 5 cases (5/11) of selected patients underwent curettage to take out fetus and placenta. The uterus preservation was achieved in all 11 patients. The complications associated with conservative management included prenatal hemorrhaging (10/11), blood transfusion (5/11), fever (2/11), and septicemia (1/11). The mean dilation of cervix was from 0cm to 1.9cm, the length of cervix was from 3.5cm to 0.6cm and the Bishop scores were from 1.5 to 7.3 after using CDB, the changes of cervical conditions were statistically significant (p＜0.05). The levels of WBC and CRP were higher after termination with medicine+UAE+CDB and/or curettage. Conclusion The adjuvant therapy of UAE, CDB, and/curettage step by step is a preferred choice for patients with CPP who underwent pregnancy termination in the second trimester.

scholarly journals Pathological Findings in a Case of Failed Uterine Artery Embolization for Placenta Previa

2013 ◽  
Vol 4 ◽  
pp. JCM.S11317 ◽  
Author(s):  
Natsuko Wada ◽  
Daisuke Tachibana ◽  
Kayoko Nakagawa ◽  
Hiroyuki Terada ◽  
Akemi Nakano ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Placenta Previa ◽  
Hypovolemic Shock ◽  
Massive Bleeding ◽  
Massive Hemorrhage ◽  
Gelatin Sponge ◽  
Pathological Findings ◽  
Artery Embolization

The reported success rate of uterine artery embolization (UAE) for obstetrical hemorrhage is more than 90%. We experienced a case of failed UAE for postpartum hemorrhage, although an embolic particle was found pathologically in the uterine vessels without coagulation. A 42-year-old woman (gravida 7, para 2) with placenta previa had genital bleeding at 35 weeks of gestation, and cesarean section was performed. We immediately added UAE aiming to reduce massive bleeding after the cesarean section, successful embolization of the bilateral uterine arteries and internal iliac arteries were confirmed by angiography regardless the vital sign was recovered with an appropriate amount of transfusion; the massive bleeding recurred after 1 hour of UAE. Hysterectomy was performed and pathological findings of the uterus showed that there was no coagulation in the vessels, which was supposed to be observed by the effect of gelatin sponge. In addition, despite the fact that no coagulation was found, only one gelatin sponge was found in 16 slices of the uterine wall specimens. We speculate that thrombotic materials were caught in vasoconstricted vessels triggered by hypovolemic shock due to acute blood loss, and then the gelatin sponge could be washed out after recovering to normalized circulation status leading to recurrent massive hemorrhage.

scholarly journals Sepsis after uterine artery embolization-assisted termination of pregnancy with complete placenta previa: A case report

2017 ◽  
Vol 46 (1) ◽  
pp. 546-550 ◽  
Author(s):  
Yinfeng Wang ◽  
Xiufeng Huang
Keyword(s):  
Severe Sepsis ◽  
Case Report ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Placenta Previa ◽  
Termination Of Pregnancy ◽  
High Grade ◽  
Artery Embolization ◽  
High Grade Fever ◽  
Emergency Cesarean

Uterine artery embolization (UAE)-assisted induction of labor is an alternative method of managing pregnant women with complete placenta previa (CPP). Sepsis secondary to UAE, although rare, is a serious complication. We herein present a case of severe sepsis following UAE-assisted termination of a pregnancy at 27 gestational weeks in a woman with CPP. The woman developed a high-grade fever and elevated inflammatory indices following UAE. She did not recover until the infected tissue was removed by emergency cesarean section. This case suggests that the increasing use of UAE for termination of pregnancy in women with CPP requires awareness regarding the possibility of serious sepsis associated with this procedure.

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