title: A Novel and Multidisciplinary Strategy for Cesarean Delivery With Placenta Percreta: Intraoperative Embolization in a Hybrid Suite.
abstract: Cesarean deliveries in patients with placenta accreta often are accompanied by life-threatening bleeding and sometimes death. A novel, multidisciplinary approach that uses uterine embolization after cesarean delivery recently has been advocated; however, embolization in the radiology department requires transfer of postoperative patients, which could increase maternal mortality and morbidity. In a case of severe placenta accreta, we planned a stepwise treatment, including cesarean delivery without separation of the placenta followed by intraoperative uterine arterial embolization in a hybrid operating room, followed by hysterectomy a few weeks after cesarean delivery. With no postpartum bleeding, complete hysterectomy was performed uneventfully 25 days later.
authors.affiliation: From the *Department of Anesthesia, Teikyo University School of Medicine, Tokyo, Japan; and †Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Konishi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Kei
authors.initials: K
authors.lastname: Sugiki
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Shigehito
authors.initials: S
authors.lastname: Sawamura
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D010921:Placenta Accreta / Q000000981:diagnostic imaging* / Q000628:therapy*; D011247:Pregnancy