Placental uterine artery embolization followed by delayed hysterectomy for placenta percreta: A case series.

Journal Article

We describe outcomes of patients with suspected placenta percreta treated with placental uterine artery embolization (P-UAE) followed by delayed hysterectomy. This is a prospective case series of subjects from 2005 to 2018 with suspected placenta percreta who underwent P-UAE at the time of cesarean delivery followed by delayed hysterectomy. Both scheduled and unscheduled surgical cases were included. Maternal characteristics, surgical approaches, intra- and postoperative outcomes were abstracted from medical records. In total, twenty-two subjects were included. Median (interquartile range, IQR) delivery gestational age was 34.6 (31.9, 35.7) weeks, occurring as scheduled in 17 (77.3%) subjects and unscheduled in 5 (22.7%). Delayed hysterectomy was performed as scheduled in 17 (77.3%) subjects at a median (IQR) 40.5 (38.0, 44.0) days after delivery, and 5 (22.7%) subjects had a hysterectomy prior to scheduled date, median (IQR) 27.0 (17.0, 35.0) days after delivery. Indications for the 5 unscheduled hysterectomies included bleeding (n = 3) and suspected endometritis (n = 2). Three subjects (13.6%) received a blood transfusion (1, 3, 3 units) during delivery, and 7 (31.8%) were transfused during delayed hysterectomy (median [IQR] 2 [1,3] units). Three (13.6%) subjects had bladder resection at the time of hysterectomy; 1 (4.5%) had an unintentional cystotomy and 1 (4.5%) had a ureteral injury. P-UAE followed by delayed hysterectomy appears to be a safe and feasible, although appropriate patient selection and close surveillance are imperative, as 22.7% of patients underwent unscheduled hysterectomy.

Full Text

Duke Authors

Cited Authors

  • Gatta, LA; Lee, PS; Gilner, JB; Weber, JM; Adkins, L; Salinaro, JR; Habib, AS; Pabon-Ramos, W; Strickland, KC; Ronald, J; Erkanli, A; Mehdiratta, JE; Grotegut, CA; Secord, AA

Published Date

  • August 2021

Published In

Volume / Issue

  • 37 /

Start / End Page

  • 100833 -

PubMed ID

  • 34368412

Pubmed Central ID

  • PMC8326725

International Standard Serial Number (ISSN)

  • 2352-5789

Digital Object Identifier (DOI)

  • 10.1016/j.gore.2021.100833

Language

  • eng

Conference Location

  • Netherlands