Prophylactic pelvic artery catheterization and embolization in women with placenta accreta: can it prevent cesarean hysterectomy?

Abstract

We present the outcome of a relatively large cohort of women with suspected placenta accreta who underwent prophylactic pelvic artery catheterization prior to cesarean section. All pregnant women with suspected placenta accreta who delivered in one tertiary center were included in this retrospective study. All patients underwent an elective cesarean section with prophylactic pelvic artery catheterization of internal iliac arteries through femoral or brachial approach. Thirty women underwent prophylactic catheterization; placenta accreta was clinically confirmed in 25 (83.3%) cases. Embolization was performed in 23 cases (76.6%) and hysterectomy in 2 (8%). Median estimated amount of blood loss was 2000 mL (500 to 9000 mL). There were no major catheterization-related complications. Three women had a subsequent pregnancy and uncomplicated delivery by cesarean section. Prophylactic pelvic artery catheterization and embolization in women with placenta accreta is safe and effective in prevention of hysterectomy and should be considered in woman wishing to preserve fertility.