title: Prophylactic pelvic artery catheterization and embolization in women with placenta accreta: can it prevent cesarean hysterectomy?
abstract: We present the outcome of a relatively large cohort of women with suspected placenta accreta who underwent prophylactic pelvic artery catheterization prior to cesarean section. All pregnant women with suspected placenta accreta who delivered in one tertiary center were included in this retrospective study. All patients underwent an elective cesarean section with prophylactic pelvic artery catheterization of internal iliac arteries through femoral or brachial approach. Thirty women underwent prophylactic catheterization; placenta accreta was clinically confirmed in 25 (83.3%) cases. Embolization was performed in 23 cases (76.6%) and hysterectomy in 2 (8%). Median estimated amount of blood loss was 2000 mL (500 to 9000 mL). There were no major catheterization-related complications. Three women had a subsequent pregnancy and uncomplicated delivery by cesarean section. Prophylactic pelvic artery catheterization and embolization in women with placenta accreta is safe and effective in prevention of hysterectomy and should be considered in woman wishing to preserve fertility.
authors.affiliation: Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel. eyal.sivan@gmail.com
authors.forename: Eyal
authors.initials: E
authors.lastname: Sivan
authors.forename: Maya
authors.initials: M
authors.lastname: Spira
authors.forename: Reuven
authors.initials: R
authors.lastname: Achiron
authors.forename: Uri
authors.initials: U
authors.lastname: Rimon
authors.forename: Gil
authors.initials: G
authors.lastname: Golan
authors.forename: Shali
authors.initials: S
authors.lastname: Mazaki-Tovi
authors.forename: Eyal
authors.initials: E
authors.lastname: Schiff
mesh_terms: D000328:Adult; D021721:Balloon Occlusion / Q000379:methods*; D002585:Cesarean Section; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007083:Iliac Artery; D010921:Placenta Accreta / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome