title: Direct puncture embolization of the internal iliac artery during cesarean delivery for pernicious placenta previa coexisting with placenta accreta.
abstract: OBJECTIVE
  To evaluate direct puncture embolization of the internal iliac artery with hemostatic gelatin sponge particles to treat pernicious placenta previa coexisting with placenta accreta during cesarean delivery.
  
  
  METHODS
  A retrospective study was conducted of data from women with pernicious placenta previa and placenta accreta who underwent direct puncture embolization of the internal iliac artery during cesarean delivery at a center in China between September 1, 2013, and February 28, 2015. Information regarding surgical procedures, operative data, and outcomes during hospitalization were obtained from medical records.
  
  
  RESULTS
  The procedure was successful in all 16 cases included. Mean operative time was 78 minutes (range 65-90) and mean estimated blood loss was 1550 mL (range 1000-2500). Complications such as fever, buttock pain, or acute limb ischemia were not observed. The procedure was performed after partial cystectomy for two patients with bladder invasion. Postoperative Doppler imaging indicated uterine recovery and normalized uterine blood flow in all patients.
  
  
  CONCLUSIONS
  Direct puncture embolization of the internal iliac artery during cesarean delivery was a safe, effective, simple, and rapid method to control hemorrhage among women with pernicious placenta previa and placenta accreta.
authors.affiliation: Department of Obstetrics and Gynaecology, No. 202 People's Liberation Army Hospital, Shenyang, China.
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynaecology, No. 202 People's Liberation Army Hospital, Shenyang, China. Electronic address: czy740704@163.com.
authors.forename: Ju
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynaecology, No. 202 People's Liberation Army Hospital, Shenyang, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Obstetrics and Gynaecology, No. 202 People's Liberation Army Hospital, Shenyang, China.
authors.forename: Jiaxi
authors.initials: J
authors.lastname: Jin
authors.affiliation: Department of Obstetrics and Gynaecology, No. 202 People's Liberation Army Hospital, Shenyang, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Obstetrics and Gynaecology, No. 202 People's Liberation Army Hospital, Shenyang, China.
authors.forename: Wan
authors.initials: W
authors.lastname: Zhong
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D002585:Cesarean Section / Q000379:methods; D002681:China; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D061646:Operative Time; D010921:Placenta Accreta / Q000601:surgery*; D010923:Placenta Previa / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014599:Uterus / Q000000981:diagnostic imaging
keywords: Artery embolization; Hemorrhage; Pernicious placenta previa; Placenta accreta