Academic Journal
Placental uterine artery embolization followed by delayed hysterectomy for placenta percreta: A case series
| العنوان: | Placental uterine artery embolization followed by delayed hysterectomy for placenta percreta: A case series |
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| المؤلفون: | Luke A. Gatta, Paula S. Lee, Jennifer B. Gilner, Jeremy M. Weber, LaMani Adkins, Julia R. Salinaro, Ashraf S. Habib, Waleska Pabon-Ramos, Kyle C. Strickland, James Ronald, Alaattin Erkanli, Jennifer E. Mehdiratta, Chad A. Grotegut, Angeles Alvarez Secord |
| المصدر: | Gynecologic Oncology Reports, Vol 37, Iss , Pp 100833- (2021) |
| بيانات النشر: | Elsevier, 2021. |
| سنة النشر: | 2021 |
| المجموعة: | LCC:Gynecology and obstetrics LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
| مصطلحات موضوعية: | Placenta accreta spectrum, Morbidly adherent placenta, Postpartum hemorrhage, Uterine artery embolization, Multidisciplinary team, Massive transfusion protocol, Gynecology and obstetrics, RG1-991, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| الوصف: | 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. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2352-5789 |
| Relation: | http://www.sciencedirect.com/science/article/pii/S2352578921001375; https://doaj.org/toc/2352-5789 |
| DOI: | 10.1016/j.gore.2021.100833 |
| URL الوصول: | https://doaj.org/article/e276d0cf0aca4493832b174bfd1177e7 |
| رقم الانضمام: | edsdoj.276d0cf0aca4493832b174bfd1177e7 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 23525789 |
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| DOI: | 10.1016/j.gore.2021.100833 |