Value of pelvic embolization in the management of severe postpartum hemorrhage due to placenta accreta, increta or percreta.

Objectives: To evaluate the role, efficacy and safety of pelvic embolization in the management of severe postpartum hemorrhage in women with placenta accreta, increta or percreta.

Methods: The clinical files and angiographic examinations of 12 consecutive women with placenta accreta (n=4), increta (n=2) or percreta (n=6) who were treated with pelvic embolization because of severe primary (n=10) or secondary (n=2) postpartum hemorrhage were reviewed. Before embolization, four women had complete placental conservation, four had partial placental conservation, three had an extirpative approach and one had hysterectomy after failed partial conservative approach.

Preoperative detection of hepatic metastases: comparison of diffusion-weighted, T2-weighted fast spin echo and gadolinium-enhanced MR imaging using surgical and histopathologic findings as standard of reference.

Purpose: The purpose of this study was to retrospectively compare the respective sensitivities of diffusion-weighted (DW), T2-weighted fast spin-echo (T2WFSE) and gadolinium chelate-enhanced MR imaging in the preoperative detection of hepatic metastases using intraoperative ultrasonographic and histopathologic findings as the standard of reference.

Materials And Methods: Twenty-seven patients with 64 surgically and histopathologically proven hepatic metastases had MR imaging of the liver, including DW, T2WFSE and dynamic gadolinium chelate-enhanced MR imaging. Images from each MR sequence were separately analyzed by two readers with disagreements resolved by consensus readings.