Application of 3-D Angiography in the Management of Placenta Percreta Treated with Repeat Uterine Artery Embolization
Abstract Background Rising Caesarean section rates have increased rates of abnormally invasive placentation. In the management of such invasive placentation, hysterectomy may result in greater morbidity than more conservative measures. Non-surgical interventions such as uterine artery embolization (...
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| Veröffentlicht in: | Journal of obstetrics and gynaecology Canada 2010-08, Vol.32 (8), p.775-779 |
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| container_title | Journal of obstetrics and gynaecology Canada |
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| creator | El-Messidi, Amira, MD, FRCSC Morissette, Cathie, RDMS Faught, Wylam, MD, FRCSC Oppenheimer, Lawrence, MBBS, FRCOG, FRCSC |
| description | Abstract Background Rising Caesarean section rates have increased rates of abnormally invasive placentation. In the management of such invasive placentation, hysterectomy may result in greater morbidity than more conservative measures. Non-surgical interventions such as uterine artery embolization (UAE) attempt to decrease placental perfusion and augment placental resorption. Repeat UAE may decrease the risk of unpredictable hemorrhage requiring emergency intervention. Three-dimensional angiography is a novel technology for assessing volume with objective measures of internal flow. Case We report a case of placenta previa percreta that was treated conservatively by repeat UAE for persistent densely perfused placenta. Three-dimensional angiography was used to objectively assess placental characterization and vascularization. Conclusion Repeat UAE may be beneficial in reducing the risk of delayed hemorrhage in women with placenta previa accreta or percreta managed conservatively. Objective assessment of placental volume and vascularity by 3-D angiography can provide data on patients at risk and allow case selection for repeat UAE. |
| doi_str_mv | 10.1016/S1701-2163(16)34620-5 |
| format | Article |
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In the management of such invasive placentation, hysterectomy may result in greater morbidity than more conservative measures. Non-surgical interventions such as uterine artery embolization (UAE) attempt to decrease placental perfusion and augment placental resorption. Repeat UAE may decrease the risk of unpredictable hemorrhage requiring emergency intervention. Three-dimensional angiography is a novel technology for assessing volume with objective measures of internal flow. Case We report a case of placenta previa percreta that was treated conservatively by repeat UAE for persistent densely perfused placenta. Three-dimensional angiography was used to objectively assess placental characterization and vascularization. Conclusion Repeat UAE may be beneficial in reducing the risk of delayed hemorrhage in women with placenta previa accreta or percreta managed conservatively. Objective assessment of placental volume and vascularity by 3-D angiography can provide data on patients at risk and allow case selection for repeat UAE.</description><identifier>ISSN: 1701-2163</identifier><identifier>DOI: 10.1016/S1701-2163(16)34620-5</identifier><identifier>PMID: 21050511</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Adult ; Angiography - methods ; conservative management ; Embolization, Therapeutic ; Female ; flow index ; Humans ; Imaging, Three-Dimensional ; mean grey index ; MGI ; Obstetrics and Gynecology ; placenta accreta ; Placenta Accreta - diagnostic imaging ; Pregnancy ; previa ; pulsatility index ; resistance index ; three-dimensional ultrasound ; UAE ; Ultrasonography ; Uterine Artery ; Uterine artery embolization ; vascularization flow index ; vascularization index ; VFI</subject><ispartof>Journal of obstetrics and gynaecology Canada, 2010-08, Vol.32 (8), p.775-779</ispartof><rights>Society of Obstetricians and Gynaecologists of Canada</rights><rights>2010 Society of Obstetricians and Gynaecologists of Canada</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-37077392cddcd846a68950e28f2684ee68d2b50ffc2f73a66a786631ea8d2f6c3</citedby><cites>FETCH-LOGICAL-c419t-37077392cddcd846a68950e28f2684ee68d2b50ffc2f73a66a786631ea8d2f6c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21050511$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>El-Messidi, Amira, MD, FRCSC</creatorcontrib><creatorcontrib>Morissette, Cathie, RDMS</creatorcontrib><creatorcontrib>Faught, Wylam, MD, FRCSC</creatorcontrib><creatorcontrib>Oppenheimer, Lawrence, MBBS, FRCOG, FRCSC</creatorcontrib><title>Application of 3-D Angiography in the Management of Placenta Percreta Treated with Repeat Uterine Artery Embolization</title><title>Journal of obstetrics and gynaecology Canada</title><addtitle>J Obstet Gynaecol Can</addtitle><description>Abstract Background Rising Caesarean section rates have increased rates of abnormally invasive placentation. In the management of such invasive placentation, hysterectomy may result in greater morbidity than more conservative measures. Non-surgical interventions such as uterine artery embolization (UAE) attempt to decrease placental perfusion and augment placental resorption. Repeat UAE may decrease the risk of unpredictable hemorrhage requiring emergency intervention. Three-dimensional angiography is a novel technology for assessing volume with objective measures of internal flow. Case We report a case of placenta previa percreta that was treated conservatively by repeat UAE for persistent densely perfused placenta. Three-dimensional angiography was used to objectively assess placental characterization and vascularization. Conclusion Repeat UAE may be beneficial in reducing the risk of delayed hemorrhage in women with placenta previa accreta or percreta managed conservatively. Objective assessment of placental volume and vascularity by 3-D angiography can provide data on patients at risk and allow case selection for repeat UAE.</description><subject>Adult</subject><subject>Angiography - methods</subject><subject>conservative management</subject><subject>Embolization, Therapeutic</subject><subject>Female</subject><subject>flow index</subject><subject>Humans</subject><subject>Imaging, Three-Dimensional</subject><subject>mean grey index</subject><subject>MGI</subject><subject>Obstetrics and Gynecology</subject><subject>placenta accreta</subject><subject>Placenta Accreta - diagnostic imaging</subject><subject>Pregnancy</subject><subject>previa</subject><subject>pulsatility index</subject><subject>resistance index</subject><subject>three-dimensional ultrasound</subject><subject>UAE</subject><subject>Ultrasonography</subject><subject>Uterine Artery</subject><subject>Uterine artery embolization</subject><subject>vascularization flow index</subject><subject>vascularization index</subject><subject>VFI</subject><issn>1701-2163</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkV9vFCEUxXnQtLX6ETS8qQ-j_Flg5kWzqW01qbHR9pmwzJ1d6gxMgdGsn77MbtsHX5qQcC-c-zvhgNBrSj5QQuXHX1QRWjEq-Tsq3_OFZKQSz9DR4_EhepHSDSFCcdUcoENGiSCC0iM0Lcexd9ZkFzwOHebVF7z0axfW0YybLXYe5w3g78abNQzg8yy67I0tpcGXEG2EUlxFMBla_NflDf4JY-nwdYboPOBlLMUWnw6r0Lt_O6eX6Hln-gSv7vdjdH12enXytbr4cf7tZHlR2QVtcsUVUYo3zLatbeuFNLJuBAFWd0zWCwBZt2wlSNdZ1ilupDSqlpJTMOWik5Yfo7d77hjD7QQp68ElC31vPIQpaSULSDLWFKXYK20MKUXo9BjdYOJWU6LnkPUuZD2nqUu3C1mLMvfm3mFaDdA-Tj0kXASf9wIo7_zjIOpkHXgLrYtgs26De9Li038E2ztf_qz_DVtIN2GKvoSoqU5Mkz1kZpQ1EwS_A1Agovs</recordid><startdate>20100801</startdate><enddate>20100801</enddate><creator>El-Messidi, Amira, MD, FRCSC</creator><creator>Morissette, Cathie, RDMS</creator><creator>Faught, Wylam, MD, FRCSC</creator><creator>Oppenheimer, Lawrence, MBBS, FRCOG, FRCSC</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100801</creationdate><title>Application of 3-D Angiography in the Management of Placenta Percreta Treated with Repeat Uterine Artery Embolization</title><author>El-Messidi, Amira, MD, FRCSC ; Morissette, Cathie, RDMS ; Faught, Wylam, MD, FRCSC ; Oppenheimer, Lawrence, MBBS, FRCOG, FRCSC</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-37077392cddcd846a68950e28f2684ee68d2b50ffc2f73a66a786631ea8d2f6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Angiography - methods</topic><topic>conservative management</topic><topic>Embolization, Therapeutic</topic><topic>Female</topic><topic>flow index</topic><topic>Humans</topic><topic>Imaging, Three-Dimensional</topic><topic>mean grey index</topic><topic>MGI</topic><topic>Obstetrics and Gynecology</topic><topic>placenta accreta</topic><topic>Placenta Accreta - diagnostic imaging</topic><topic>Pregnancy</topic><topic>previa</topic><topic>pulsatility index</topic><topic>resistance index</topic><topic>three-dimensional ultrasound</topic><topic>UAE</topic><topic>Ultrasonography</topic><topic>Uterine Artery</topic><topic>Uterine artery embolization</topic><topic>vascularization flow index</topic><topic>vascularization index</topic><topic>VFI</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>El-Messidi, Amira, MD, FRCSC</creatorcontrib><creatorcontrib>Morissette, Cathie, RDMS</creatorcontrib><creatorcontrib>Faught, Wylam, MD, FRCSC</creatorcontrib><creatorcontrib>Oppenheimer, Lawrence, MBBS, FRCOG, FRCSC</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of obstetrics and gynaecology Canada</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>El-Messidi, Amira, MD, FRCSC</au><au>Morissette, Cathie, RDMS</au><au>Faught, Wylam, MD, FRCSC</au><au>Oppenheimer, Lawrence, MBBS, FRCOG, FRCSC</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Application of 3-D Angiography in the Management of Placenta Percreta Treated with Repeat Uterine Artery Embolization</atitle><jtitle>Journal of obstetrics and gynaecology Canada</jtitle><addtitle>J Obstet Gynaecol Can</addtitle><date>2010-08-01</date><risdate>2010</risdate><volume>32</volume><issue>8</issue><spage>775</spage><epage>779</epage><pages>775-779</pages><issn>1701-2163</issn><abstract>Abstract Background Rising Caesarean section rates have increased rates of abnormally invasive placentation. In the management of such invasive placentation, hysterectomy may result in greater morbidity than more conservative measures. Non-surgical interventions such as uterine artery embolization (UAE) attempt to decrease placental perfusion and augment placental resorption. Repeat UAE may decrease the risk of unpredictable hemorrhage requiring emergency intervention. Three-dimensional angiography is a novel technology for assessing volume with objective measures of internal flow. Case We report a case of placenta previa percreta that was treated conservatively by repeat UAE for persistent densely perfused placenta. Three-dimensional angiography was used to objectively assess placental characterization and vascularization. Conclusion Repeat UAE may be beneficial in reducing the risk of delayed hemorrhage in women with placenta previa accreta or percreta managed conservatively. Objective assessment of placental volume and vascularity by 3-D angiography can provide data on patients at risk and allow case selection for repeat UAE.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>21050511</pmid><doi>10.1016/S1701-2163(16)34620-5</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Angiography - methods conservative management Embolization, Therapeutic Female flow index Humans Imaging, Three-Dimensional mean grey index MGI Obstetrics and Gynecology placenta accreta Placenta Accreta - diagnostic imaging Pregnancy previa pulsatility index resistance index three-dimensional ultrasound UAE Ultrasonography Uterine Artery Uterine artery embolization vascularization flow index vascularization index VFI |
| title | Application of 3-D Angiography in the Management of Placenta Percreta Treated with Repeat Uterine Artery Embolization |
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