title: Prophylactic trans-uterine embolization to reduce intraoperative blood loss for placenta percreta invading the urinary bladder.
abstract: Reported herein is the case of a 35-year-old multipara woman diagnosed (on sonography) with total placenta previa that had ruptured through the myometrium of the uterus, invading the wall of the urinary bladder. In the 32nd week of gestation the patient underwent an emergency cesarean section due to profuse vaginal bleeding. Due to possible intraoperative massive bleeding during removal of the placenta it was decided to preserve the uterus and placenta temporarily. The patient underwent superselective trans-uterine embolization through the bilateral anterior branches of the hypogastric arteries, using gelfoam cubes and coils. Two days later cesarean hysterectomy was performed, and the placenta was successfully removed from the invaded urinary bladder. The whole procedure went smoothly and the estimated blood loss was only 1300 mL.
authors.affiliation: Department of Diagnostic Radiology, Medical College, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Ting-Kai
authors.initials: TK
authors.lastname: Leung
authors.forename: Heng-Kien
authors.initials: HK
authors.lastname: Au
authors.forename: Yun-Ho
authors.initials: YH
authors.lastname: Lin
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Lee
authors.forename: Li-Kuo
authors.initials: LK
authors.lastname: Shen
authors.forename: Wei-Hsing
authors.initials: WH
authors.lastname: Lee
authors.forename: Hung-Jung
authors.initials: HJ
authors.lastname: Wang
authors.forename: Wen-Tien
authors.initials: WT
authors.lastname: Hsiao
authors.forename: Ya-Yen
authors.initials: YY
authors.lastname: Chen
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002585:Cesarean Section; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D010921:Placenta Accreta / Q000601:surgery*; D011247:Pregnancy; D014592:Uterine Hemorrhage / Q000517:prevention & control*