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A Novel and Multidisciplinary Strategy for Cesarean Delivery With Placenta Percreta: Intraoperative Embolization in a Hybrid Suite.

Research paper by Yasutaka Y Konishi, Satoshi S Yamamoto, Kei K Sugiki, Hidetoshi H Sakamoto, Shigehito S Sawamura

Indexed on: 29 Jul '16Published on: 29 Jul '16Published in: A & A case reports



Abstract

Cesarean deliveries in patients with placenta accreta often are accompanied by life-threatening bleeding and sometimes death. A novel, multidisciplinary approach that uses uterine embolization after cesarean delivery recently has been advocated; however, embolization in the radiology department requires transfer of postoperative patients, which could increase maternal mortality and morbidity. In a case of severe placenta accreta, we planned a stepwise treatment, including cesarean delivery without separation of the placenta followed by intraoperative uterine arterial embolization in a hybrid operating room, followed by hysterectomy a few weeks after cesarean delivery. With no postpartum bleeding, complete hysterectomy was performed uneventfully 25 days later.