Comparison of One-Stage and Two-Stage Intraoperative Uterine Artery Embolization during Cesarean Delivery for Placenta Accreta: Report of Two Clinical Cases at a Tertiary Referral Medical Center

Zhu-Wei Lim; Wei-Yang Lee; Yuan-Chun Huang; Wan-Ju Wu; Ming Chen

doi:10.3390/healthcare10050774

Comparison of One-Stage and Two-Stage Intraoperative Uterine Artery Embolization during Cesarean Delivery for Placenta Accreta: Report of Two Clinical Cases at a Tertiary Referral Medical Center

Healthcare (Basel). 2022 Apr 22;10(5):774. doi: 10.3390/healthcare10050774.

Authors

Zhu-Wei Lim¹, Wei-Yang Lee², Yuan-Chun Huang², Wan-Ju Wu^{1

3

4}, Ming Chen^{1

4

5

6

7

8

9}

Affiliations

¹ Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua 50006, Taiwan.
² Department of Medical Imaging, Changhua Christian Hospital, Changhua 50006, Taiwan.
³ Programs in Translational Medicine, National Chung Hsing University, Taichung 40227, Taiwan.
⁴ Department of Genomic Medicine and Center for Medical Genetics, Changhua Christian Hospital, Changhua 50046, Taiwan.
⁵ Department of Medical Research, Changhua Christian Hospital, Changhua 50006, Taiwan.
⁶ Department of Biomedical Science, Dayeh University, Changhua 51591, Taiwan.
⁷ Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei 10041, Taiwan.
⁸ Department of Medical Genetics, National Taiwan University Hospital, Taipei 10041, Taiwan.
⁹ Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan.

Abstract

Placenta accreta spectrum (PAS) described the anchoring placental villi attached or penetrating into/through the myometrium. PAS is clinically important because of the unpredictable bleeding amount when manually removing the defective decidualization at the endometrial-myometrial interface. Therefore, a multidisciplinary strategy for cesarean delivery with PAS is crucial. Postoperative embolization after cesarean hysterectomy in a hybrid suite was studied by many scientists. In this study, we demonstrated two cases of intraoperative embolization without hysterectomy in a hybrid operating room for cesarean delivery with placenta accreta. Our results show that intraoperative uterine artery embolization with a hybrid suite is a time-preserving and safe method for cesarean delivery with PAS owing to avoiding the risk of morbidity and mortality during patient transfer.

Keywords: hybrid OR; morbidly adherent placenta; multidisciplinary team; placenta accreta spectrum (PAS); uterine artery embolization (UAE).