Placenta accreta is a rare but potentially lethal obstetric emergency due to massive hemorrhage, uterine perforation, and infection. Traditionally, hysterectomy was performed in the occurrence of serious hemorrhage. Currently, several conservative treatments including the use of uterine packing, leaving the placenta in situ, argon-beam coagulation, uterine artery ligation, administration of methotrexate, and uterine artery embolizations are introduced to preserve future reproductive potential. We present a patient with placenta accreta treated successfully with selective uterine artery embolization followed by methotrexate with brief review of literature.
Emergencies ; Hemorrhage ; Humans ; Hysterectomy ; Ligation ; Methotrexate* ; Placenta Accreta* ; Placenta* ; Uterine Artery Embolization* ; Uterine Artery* ; Uterine Hemorrhage

Cesarean scar pregnancy, in which the pregnancy is implanted at the previous cesarean scar, is a very rare form of ectopic pregnancy. A delay in diagnosis can lead to uterine rupture, massive hemorrhage, and serious maternal morbidity. However, the optimal treatment is unknown. We experienced a case of viable cesarean scar pregnancy diagnosed at 13 weeks of gestation treated with uterine artery embolization and report with a brief of literatures.
Cicatrix ; Female ; Hemorrhage ; Pregnancy ; Pregnancy, Ectopic ; Uterine Artery ; Uterine Artery Embolization ; Uterine Rupture

Uterine fibroids are the most common benign tumor of the female genital tract. Traditional therapy for symptomatic fibroids has been either myomectomy or hysterectony, depending on whether futhur fertility is desire. A promised new altermative therapy-embolization of the uterine arteries- is now available. A 29 year-old woman was diagnosed of uterine fibroid by ultrasonogram and other techniques. We have experienced one case of uterine fibroid necrosis after transarterial embolization. Now we report a case of uterine artery embolization for treattement of uterine fibriods with a brief review.
Adult ; Female ; Fertility ; Humans ; Leiomyoma* ; Necrosis* ; Ultrasonography ; Uterine Artery Embolization

We report a case of unrecognized uterine inversion was restored spontaneously without surgical intervention. Initially, the case was diagnosed as uterine atony and not uterine inversion and was managed successfully with uterine artery embolization. However, a partial uterine inversion was detected on a subsequent scheduled pelvic examination. Fortunately, her uterus was completely restored without any surgical intervention on eighth week after delivery.
Gynecological Examination ; Postpartum Hemorrhage ; Uterine Artery Embolization ; Uterine Inertia ; Uterine Inversion* ; Uterus

OBJECTIVE: The aim of our study is to evaluate the effect of uterine artery embolization as primary treatment for symptomatic uterine fibroid METHODS: From December 1999 to December 2004, 25 patients underwent uterine artery embolization for the treatment of uterine fibroid. The patients were followed up at regular intervals (at 1st, 3rd, 6th month and annual) for 3 years. The mean duration of follow-up was about 41 month (range; 41+/-15). During follow-up period, consecutive uterine and fibroid volume, and symptoms were checked. RESULTS: The uterine volumes were significantly reduced by 27% (P=0.0238) after 3month. And the fibroid volumes were significantly reduced by 59% (P=0.0070) after 1month. The uterine volumes were significantly reduced by 27% (P=0.0082) after 3 years. And the fibroid volumes were significantly reduced by 60% (P=0.0445) after 3 years. All women reported noticeable improvement of menorrhagia after complete of follow up. But, two of nine women who had symptoms of dysmenorrhea or lower abdominal pain, showed no changes in symptoms CONCLUSION: Uterine artery embolization appears to be effective in controlling symptoms, and substantially reducing uterine and fibroid volume with few complication after 3 years. However, long term follow-up will be necessary to establish the efficacy of this procedure.
Abdominal Pain ; Dysmenorrhea ; Female ; Follow-Up Studies ; Humans ; Leiomyoma* ; Menorrhagia ; Uterine Artery Embolization* ; Uterine Artery*

A 35 year old woman, gravid 5, multiparous, was admitted to our department at 6 weeks and 5 days of gestation after being diagnosed with cervical pregnancy. Before the evacuation, the uterine arteries were embolized using angiographic techniques. As a result, dilatation and curettage were performed with minimal hemorrhage. We report one case of cervical pregnancy managed, successfully with preoperative uterine artery embolization and evacuation.
Adult ; Dilatation and Curettage ; Female ; Hemorrhage ; Humans ; Pregnancy* ; Uterine Artery Embolization* ; Uterine Artery*

The transobturator tape (TOT) procedure is a relatively safer than tension-free vaginal tape (TVT) operation but it may cause vascular injury. Recently we experienced a case using uterine artery embolization for the patient with uterine artery bleeding after TOT.
Hemorrhage* ; Humans ; Suburethral Slings* ; Uterine Artery Embolization* ; Uterine Artery* ; Vascular System Injuries

Selective uterine arterial embolization is widely used in the management of obstetric hemorrhage. Owing to the physiological changes associated with pregnancy and selection of uterine arteries, ischemic injury after uterine arterial embolization in postpartum bleeding is rare. In previous reports, the known causes of ischemic injury after embolization are using the too small particle and complete occlusion of fine branch of uterine artery with absence of collateral ovarian artery. We experienced uterine necrosis despite partial obstruction of uterine arteries following the selective embolization. We report this case with brief review of literature
Arteries ; Hemorrhage ; Necrosis ; Postpartum Hemorrhage ; Postpartum Period ; Pregnancy ; Uterine Artery ; Uterine Artery Embolization

Embolization of the uterine arteries is a valuable method for controlling postpartum hemorrhage. There have been recent attempts to apply this tool as a means of controlling bleeding during Cesarean section, especially in patients with placenta previa. However, the benefits are controversial due to lack of randomized controlled studies, no evidence of significant improved outcomes, and potential harm including radiation exposure. This paper includes two case reports of intraoperative uterine artery embolization without fetal radiation exposure in patients with placenta previa totalis.
Cesarean Section ; Female ; Hemorrhage ; Humans ; Placenta ; Placenta Previa ; Postpartum Hemorrhage ; Pregnancy ; Uterine Artery ; Uterine Artery Embolization

PURPOSE: The purpose of this study was to develop a Critical Pathway for Uterine Artery Embolization patients. METHOD: There were 6 steps that were taken. Step 1 was selecting a diagnosis, and Step 2 was organizing a development team consisting of 7 experts. Step 3 analyzed the medical records, and Step 4 drew up a preliminary Critical Pathway. Step 5 tested the clinical validity of the preliminary Critical Pathway, and Step 6 developed the final Critical Pathway. RESULT: The contents of the medical practices observed in the medical records were investigated in seven areas: monitoring/assessment, treatment, medication, diet, activity, consults, and education/discharge plan; and a total of 73 items was identified. The validity of the 73 items was examined by a group of specialists. 68 items were adopted, 4 items revised, 1 item removed, and 1 item was added. Using the results, a preliminary Critical Pathway was drawn up. According to the results from examining the clinical validity of the preliminary Critical Pathway with five patients for five weeks, 3 items which showed discrepancy were revised and another 3 items were added. Then, the final Critical Pathway was completed. CONCLUSION: This Critical Pathway needs to be clinically applied and continuously to measure its effects in terms of the length of stay, cost?effectiveness, and the patients' and staffs' satisfaction.
Critical Pathways* ; Diagnosis ; Diet ; Humans ; Length of Stay ; Medical Records ; Specialization ; Uterine Artery Embolization* ; Uterine Artery*