Uterine Artery Embolization following Cesarean Delivery but prior to Hysterectomy in the Management of Patients with Invasive Placenta.
Adult
Blood Loss, Surgical
/ prevention & control
Blood Transfusion
Cesarean Section
/ adverse effects
Female
Humans
Hysterectomy
/ adverse effects
Length of Stay
Placenta Accreta
/ diagnostic imaging
Pregnancy
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Uterine Artery Embolization
/ adverse effects
Journal
Journal of vascular and interventional radiology : JVIR
ISSN: 1535-7732
Titre abrégé: J Vasc Interv Radiol
Pays: United States
ID NLM: 9203369
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
08
06
2018
revised:
04
12
2018
accepted:
06
12
2018
pubmed:
30
3
2019
medline:
25
12
2019
entrez:
30
3
2019
Statut:
ppublish
Résumé
To evaluate outcomes of patients with placenta accreta spectrum (PAS) disorders who underwent uterine artery embolization (UAE) following cesarean delivery but before hysterectomy. A retrospective review of patients with PAS treated with cesarean-hysterectomy (C-hyst) was performed. Patients in the UAE group underwent UAE after cesarean delivery but before hysterectomy; patients in the control group underwent C-hyst alone. Estimated blood loss (EBL), transfusion requirements, length of intensive care unit (ICU) stay, and adverse events were evaluated. The study included 31 patients, 7 in the UAE group and 24 in the control group. Median EBL, transfusion requirements, and length of ICU stay in the UAE group compared with control group were 1,500 mL (range, 500-2,000 mL) vs 2,000 mL (range, 1,000-4,500 mL) (P = .04), 150 mL (range, 0-650 mL) vs 550 mL (range, 0-3,125 mL) (P = .10), and 0 d (range, 0-1 d) vs 0.5 d (range, 0-2 d) (P = .07). All patients in the UAE group had placenta increta; patients in the control group had placenta accreta (29%), increta (54%), and percreta (17%) (P = .10). Subgroup analysis of patients with placenta increta demonstrated that the UAE group had a significant decrease in median EBL (P = .004), transfusion requirements (P = .009), and length of ICU stay (P = .04). No adverse events following UAE were noted. UAE following cesarean delivery but before hysterectomy in patients with placenta increta appears to be safe and effective in decreasing EBL, transfusion requirements, and length of ICU stay compared with C-hyst alone.
Identifiants
pubmed: 30922797
pii: S1051-0443(18)31773-1
doi: 10.1016/j.jvir.2018.12.007
pmc: PMC10468213
mid: NIHMS1926800
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
687-691Subventions
Organisme : NIAID NIH HHS
ID : K08 AI137209
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2018 SIR. Published by Elsevier Inc. All rights reserved.
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