Successful use of uterine artery embolisation to treat placenta increta in the first trimester.
A 39-year-old Asian woman was admitted to hospital with persistent, heavy vaginal bleeding following an uncomplicated first trimester surgical termination of pregnancy (STOP). Her heavy bleeding continued after the STOP and she had recurrent hospital admissions which included two procedures to evacuate presumed retained products of conception. She eventually had a MRI scan performed which suggested placental tissue in the fundal region, extended into the uterine wall. The findings were consistent with placenta increta and the patient had a bilateral uterine artery embolisation (UAE), following which her symptoms rapidly subsided. We describe the first successfully managed case of persistent vaginal bleeding secondary to abnormal placentation. It would seem to substantiate the efficacy of UAE as a therapeutic modality for the conservative management of invasive placentation in the first trimester of pregnancy.
Soleymani Majd
Hooman
H
Department of Obstetrics and Gynaecology, Milton Keynes General Hospital NHS Trust, Milton Keynes, UK. hooman_sm@yahoo.com
Srikantha
Maithili
M
Majumdar
Subrata
S
B-Lynch
Christopher
C
Choji
Kiyoshi
K
Canthaboo
Manivannan
M
Ismail
Lamiese
L
D000028:Abortion, Induced / Q000009:adverse effects*; D000328:Adult; D005260:Female; D006801:Humans; D010921:Placenta Accreta / Q000601:surgery*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D055357:Uterine Artery Embolization; D014592:Uterine Hemorrhage / Q000209:etiology / Q000601:surgery