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. 2019 Jan;47(1):345-352.
doi: 10.1177/0300060518801455. Epub 2018 Oct 14.

Prophylactic uterine artery embolization in second-trimester pregnancy termination with complete placenta previa

Yinfeng Wang  1 , Changchang Hu  1 , Ningpin Pan  1 , Chaolu Chen  1 , Ruijin Wu  1
Affiliations

Prophylactic uterine artery embolization in second-trimester pregnancy termination with complete placenta previa

Yinfeng Wang et al. J Int Med Res. 2019 Jan.

Abstract

Objective: This study was performed to assess whether prophylactic uterine artery embolization (UAE) is beneficial for second-trimester abortion with complete placenta previa (CPP).

Methods: Patients with CPP who underwent second-trimester pregnancy termination by labor induction with or without UAE from January 2010 to January 2018 were retrospectively reviewed. In total, 25 patients were eligible for analysis. The primary outcomes were the abortion success rate and bleeding volume, and the secondary outcomes were the induction-to-abortion time, length of hospital stay, and complications.

Results: CPP occurred in all 25 patients. Fifteen patients underwent prophylactic UAE (UAE group) and 10 did not (control group). Abortion was successful in 13 of 15 (86.7%) women in the UAE group and in 9 of 10 (90.0%) women in the control group. There was no significant difference in the bleeding volume or induction-to-abortion time between the two groups. The hospital stay was longer and pyrexia was more common in the UAE than control group.

Conclusion: Prophylactic UAE did not markedly improve the outcomes of second-trimester abortion in patients with CPP. Conversely, it may increase the risk of complications and prolong the hospital stay.

Keywords: Uterine artery embolization; placenta previa; postpartum hemorrhage; second trimester; sepsis; termination of pregnancy.

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Figures

Figure 1.
Figure 1.
Ultrasound and magnetic resonance imaging findings. (a) Transabdominal ultrasonographic image and (b) T2-weighted magnetic resonance image showing the placenta (white arrow) completely covering the cervical os (black arrow) without signs of placenta accreta. Arrowhead: bladder
Figure 2.
Figure 2.
Angiography findings. Angiograms of the right uterine artery revealed (a) diffuse contrast staining before embolization and (b) devascularized placenta after embolization (white arrow: initial point of uterine artery)
See this image and copyright information in PMC

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