Pregnancy outcome of uterine arterial embolization followed by selective hysteroscopic removal of a placental polyp.
OBJECTIVE
To evaluate the pregnancy outcome of uterine arterial embolization followed by selective hysteroscopic removal of a placental polyp.


METHODS
Thirteen patients of placental polyp with abundant blood flow, which was diagnosed by ultrasound with color Doppler imaging, were studied. They underwent uterine arterial embolization followed by selective hysteroscopic removal of the polyp. Uterine arterial embolization was carried out using an absorbable gelatin sponge. Selective removal via hysteroscopy was performed on the following day, using the cutting loop with or without electrical stimulation. The polyp was gradually resected to the level of the surrounding endometrium.


RESULTS
Complete removal of the placental polyp was achieved in all patients. The presence of placental polyp was confirmed by pathologic examination. The operative time ranged from 20 to 53 min. In all cases, no complications were noted and the bleeding was minimal during and immediately after the procedure. Postoperative ultrasound demonstrated a uterine cavity free of residual mass in each case. The seven patients with complete gestation gave birth to health babies. No recurrence of placental polyp was observed.


CONCLUSIONS
Selective removal directed via hysteroscopy after reduction of blood supply by uterine arterial embolization provides a safe and effective method to minimize bleeding, and can preserve future fertility and successful uneventful pregnancies in the treatment of placental polyp with abundant blood flow.
Takeuchi
Kyousuke
K
Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
Sugimoto
Makoto
M
Kitao
Keisuke
K
Yoshida
Shigeki
S
Maruo
Takeshi
T
D000328:Adult; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D010922:Placenta Diseases / Q000628:therapy*; D011127:Polyps / Q000628:therapy*; D006473:Postpartum Hemorrhage / Q000517:prevention & control; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000628:therapy*; D011256:Pregnancy Outcome