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The Role of Interventional Radiology in Managing Placenta Accreta Spectrum Disorder.
Clin Obstet Gynecol
January 2025
Department of Radiology, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts.
Interventional Radiology (IR) can be a crucial player in managing placenta accrete spectrum disorder (PAS), offering minimally invasive angiographic techniques that can prevent or control hemorrhage and preserve fertility. These include prophylactic balloon occlusion of the aorta or iliac arteries, preoperative catheter placement in the iliac or uterine arteries for subsequent embolization, or pre-emptive arterial embolization preceding hysterotomy and delivery. This review provides obstetricians with an overview of IR's role in the management of PAS by describing specific endovascular techniques; existing outcomes data; and considerations for protocol development, preoperative planning, and intraoperative dynamics for when IR assists with PAS cases.
View Article and Find Full Text PDFPlacental Adhesion Subsequent to Uterine Preservation via Resuscitative Endovascular Balloon Occlusion of the Aorta: A Case Report.
Cureus
December 2024
Department of Obstetrics and Gynecology Faculty of Medicine, Fukuoka University, Fukuoka, JPN.
An adherent placenta is a life-threatening condition that impairs the mother's life owing to hemorrhagic shock and disseminated intravascular coagulation. Profound hemorrhage resulting from placental abruption is often managed using hysterectomy to preserve the mother's life, although the consequent loss of fertility can be devastating, particularly in younger women. Thus, strategies that facilitate fertility preservation while effectively controlling hemorrhage should be considered viable alternatives.
View Article and Find Full Text PDFBackground Uterine isthmocele, a defect in the uterine wall at the cesarean scar, is increasingly recognized due to the rising rate of cesarean deliveries. Often asymptomatic, it may lead to complications such as abnormal bleeding, chronic pelvic pain, secondary infertility, or uterine rupture during subsequent pregnancies. Objective This study aimed to assess the prevalence, clinical features, and associated risk factors of uterine isthmocele among women with previous cesarean scars over four years (2019-2023) at Rabia Balkhi Hospital, Afghanistan.
View Article and Find Full Text PDFIntegrative multi-omic analysis reveals potential biomarkers in the cervicovaginal fluid of patients with placenta accrete spectrum.
BMC Pregnancy Childbirth
December 2024
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Objective: This study aimed to detect the proteins and metabolites in the cervicovaginal fluid to observe their relationship with the occurrence of placenta accreta spectrum and the potential biomarkers with predictive value.
Methods: Cervicovaginal fluid samples were collected before delivery from 6 participants of PAS and 6 controls subjects with similar gestational ages. The severity of PAS was evaluated by ultrasound and MRI scoring system and confirmed by the intraoperative findings or pathological examination.
Uterine artery embolisation in symptomatic patients with placenta accreta spectrum disorders.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub
December 2024
Department of Radiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
Objectives: Postpartum haemorrhage is the most common cause of mortality among women after childbirth. Therefore, this work aims to highlight the possibility of endovascular treatment of postpartum haemorrhage due to remnants in patients with placenta accreta spectrum disorders (PAS disorders) using selective UAE after failure of the standard management. This procedure is a relatively safe and technically nondemanding, with a low risk of recurrent vaginal bleeding.
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