title: Uterine artery embolization for emergent management of postpartum hemorrhage associated with placenta accreta.
abstract: BACKGROUND
  Although uterine artery embolization (UAE) is a well-recognized alternative treatment for postpartum hemorrhage (PPH) with a high clinical efficacy, the reported success rate of UAE for PPH associated with placenta accreta (PA) is lower. Recently, with advances in techniques and expertise, a few studies have reported favorable results of UAE in controlling PPH in the setting of PA.
  
  
  OBJECTIVE
  To evaluate the efficacy of UAE in the emergent management of intractable PPH associated with PA.
  
  
  METHODS
  Seventeen consecutive patients who underwent emergent UAE for the management of PPH associated with PA were included in this retrospective study. Medical records were reviewed regarding the delivery and UAE procedure. Follow-up gynecologic outcomes after UAE were obtained by telephone interview.
  
  
  RESULTS
  UAE successfully controlled PPH in 14 patients (82.4%). Three patients underwent hysterectomy after UAE failed to stop the bleeding. All hysterectomy cases were accompanied by uterine atony or total placenta previa. Relevant gynecologic findings were obtained from 10 patients; three patients were breastfeeding and seven patients resumed normal menstruation, including one pregnancy.
  
  
  CONCLUSIONS
  UAE appears to be a safe and effective means by which to control PPH associated with PA. PA complicated by uterine atony or placenta previa may be at increased risk of UAE failure.
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hye Na
authors.initials: HN
authors.lastname: Jung
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Shin
authors.forename: Suk-Joo
authors.initials: SJ
authors.lastname: Choi
authors.forename: Sung Ki
authors.initials: SK
authors.lastname: Cho
authors.forename: Kwang Bo
authors.initials: KB
authors.lastname: Park
authors.forename: Hong Suk
authors.initials: HS
authors.lastname: Park
authors.forename: Minho
authors.initials: M
authors.lastname: Kang
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Choo
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Do
authors.forename: In-wook
authors.initials: IW
authors.lastname: Choo
mesh_terms: D000328:Adult; D000792:Angiography; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007407:Interviews as Topic; D010921:Placenta Accreta / Q000000981:diagnostic imaging / Q000628:therapy*; D006473:Postpartum Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000379:methods*