Prophylactic trans-uterine embolization to reduce intraoperative blood loss for placenta percreta invading the urinary bladder.
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.
Leung
Ting-Kai
TK
Department of Diagnostic Radiology, Medical College, Taipei Medical University Hospital, Taipei, Taiwan.
Au
Heng-Kien
HK
Lin
Yun-Ho
YH
Lee
Chi-Ming
CM
Shen
Li-Kuo
LK
Lee
Wei-Hsing
WH
Wang
Hung-Jung
HJ
Hsiao
Wen-Tien
WT
Chen
Ya-Yen
YY
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*