Prophylactic Hypogastric Artery Ballooning in a Patient with Complete Placenta Previa and Increta.
10.3346/jkms.2010.25.4.651
- Author:
Kyong Wook YI
1
;
Min Jeong OH
;
Tae Seok SEO
;
Kyeong A SO
;
Yu Chin PAEK
;
Hai Joong KIM
Author Information
1. Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Korea. mjohmd@korea.ac.kr
- Publication Type:Case Reports
- Keywords:
Placenta Increta;
Hypogastric Artery;
Balloon Occlusion
- MeSH:
Adult;
Arteries/*surgery;
*Catheterization;
Cesarean Section;
Female;
Gestational Age;
Humans;
Hysterectomy/*methods;
Placenta/*blood supply/ultrasonography;
Placenta Accreta/*surgery/ultrasonography;
Placenta Previa/*surgery/ultrasonography;
Postpartum Hemorrhage/*prevention & control;
Pregnancy;
Treatment Outcome
- From:Journal of Korean Medical Science
2010;25(4):651-655
- CountryRepublic of Korea
- Language:English
-
Abstract:
Abnormal attachment of the placenta (Placenta accreta, increta, and percreta) is an uncommon but potentially lethal cause of maternal mortality from massive postpartum hemorrhage. A 33-yr-old woman, who had been diagnosed with a placenta previa, was referred at 30 weeks gestation. On ultrasound, a complete type of placenta previa and multiple intraplacental lacunae, suggestive of placenta accreta, were noted. For further evaluation of the placenta, pelvis MRI was performed and revealed findings suspicious of a placenta increta. An elective cesarean delivery and subsequent hysterectomy were planned for the patient at 38 weeks gestation. On the day of delivery, endovascular catheters for balloon occlusion were placed within the hypogastric arteries, prior to the cesarean section. In the operating room, immediately after the delivery of the baby, bilateral hypogastric arteries were occluded by inflation of the balloons in the catheters previously placed within. With the placenta retained within the uterus, a total hysterectomy was performed in the usual fashion. The occluding balloons were deflated after closure of the vaginal cuff with hemostasis. The patient had stable vital signs and normal laboratory findings during the recovery period; she was discharged six days after delivery without complications. The final pathology confirmed a placenta increta.
