Skip to main content
SpringerLink
Log in

The Role of Interventional Radiology in the Management of Abnormal Placentation

  • Chapter
Radiological Interventions in Obstetrics and Gynaecology

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

  • 1220 Accesses

Abstract

The prevalence of placenta previa and morbidly placenta accreta is increasing as a result of the increased rate of caesarean sections. Major placenta previa and placenta previa accreta mandate delivery by caesarean section and carry the risk of massive haemorrhage and hysterectomy. Women with placenta accreta are at particular risk of major haemorrhage and its complications. The insertion of prophylactic Internal Iliac Occlusion Balloon Catheters (IIOBCs) is to be carefully considered in cases of placenta accreta and placenta previa accreta and is supported in recent published guidelines. Where IIOBCs are ineffective in controlling haemorrhage, additional gelatine foam embolisation should be considered. Prophylactic internal iliac balloon occlusion with or without embolisation has not however been demonstrated in the literature to reduce the complications of massive haemorrhage or to reduce the need for hysterectomy in placenta accreta. Complications as a result of IIOBCs are not uncommon. Many of these are related to long dwell times and displacement of the balloon catheters and may be minimised by scrupulous technique. Advances in technique, operator experience, the use of closure devices and IR suites fit for obstetric delivery may improve the efficacy and safety of the use of prophylactic IIOBCs with and without embolisation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abbas F, Talati J, Wasti S, Akram S, Ghaffar S, Qureshi R (2000) Placenta Percreta with bladder invasion as a cause of life threatening hemorrhage. J Urol 164:1270–1274

    CAS  PubMed  Google Scholar 

  • Bell-Thomas SM, Penketh RJ, Lord RH, Davies NJ, Collis R (2003) Emergency use of a transfemoral aortic occlusion catheter to controle massive haemorrhage at caesarean hysterectomy. BJOG 110:1120–1122

    Google Scholar 

  • Bishop S, Butler K, Monaghan S et al (2011) Multiple complications following the use of prophylactic internal iliac artery balloon catheterisation in a patient with placenta percreta. Int J Obstet Anesth 20:70e3. doi:10.1016/j.ijoa.2010.09.012

  • Bodner LJ, Nosher JL, Gribbin C et al (2006) Balloon-assisted occlusion of the internal iliac arteries in patients with placenta accreta/percreta. Cardiovasc Intervent Radiol 29:354e61. doi:10.1007/s00270-005-0023-2

    Article  Google Scholar 

  • Brown BJ, Heaston DK, Poulson AM, Gabert HA, Mineau DE, Miller FJ Jr (1979) Uncontrollable postpartum bleeding: a new approach to hemostasis through angiographic arterial embolization. Obstet Gynecol 54:361–365

    Google Scholar 

  • Burchell RC (1964) Internal iliac artery ligation: haemodynamics. Am J Obstet Gynecol 737–739

    Google Scholar 

  • Burchell RC, Olson G (1966) Internal Iliac Ligation: aortograms. Obstetgynecol 94:117–124

    Google Scholar 

  • Carnevale FC, Kondo MM, Oliveira Sousa W Jr et al (2011) Perioperative temporary occlusion of the internal iliac arteries as prophylaxis in cesarean section at risk of hemorrhage in placenta accreta. Cardiovasc Intervent Radiol 34:758e64. doi:10.1007/s00270-011-0166-2

    Article  Google Scholar 

  • Chait A, Moltz A, Nelson JH (1968) The collateral Arterial Circulation in the Pelvis. AJR 102:392–400

    Google Scholar 

  • Clark SL, Phelan JP, Yeh SY, Bruce SR, Paul RH (1985) Hypogastric artery ligation for obstetric hemorrhage. Obstet Gynecol 66:353–356

    CAS  PubMed  Google Scholar 

  • Clark SL, Phelan J P, Yeh S Y, Bruce S R, Paul R H (1986) Hypogastric artery ligation for obstetric hemorrhage. Obstet Gynecol 66:353–356

    Google Scholar 

  • Dubois J, Garel L, Grignon A, Lemay M, LeducL(1997) Placenta percreta: balloon occlusion and embolization of the internal iliac arteries to reduce intraoperative blood losses. Am J Obstet Gynecol 176:723–726

    Google Scholar 

  • Dwyer BK, Belogolovkin V, Tran L et al (2008) Prenatal diagnosis of placenta accreta: sonography or magnetic resonance imaging? J Ultrasound Med 27:1275e81

    Google Scholar 

  • Evans S, McShane P (1985) The efficacy of internal iliac artery ligation in obstetric hemorrhage. Surg Gynecol Obstet 160:250–253

    CAS  PubMed  Google Scholar 

  • Edwards WS, Salter PP, Carnaggio VA (1953) Intraluminal aortic occlusion as a possible mechanism for controlling massive intraabdominal hemorrhage. Surg Forum 4:496–499

    CAS  PubMed  Google Scholar 

  • Faranesh R, Romano S, Shalev E et al (2007) Suggested approach for management of placenta percreta invading the urinary bladder. Obstet Gynecol 110:512e5. doi:10.1097/01.AOG.0000267135.31817.d6

    Article  Google Scholar 

  • Hughes CW (1954) Use of an intra-aortic balloon catheter tamponade for controlling intra-abdominal hemorrhage in man. Surgery 36:65–68

    CAS  PubMed  Google Scholar 

  • Hansch E, Chitkara U, McAlpine J, El-Sayed Y, Dake MD, Razavi MK (1999) Pelvic arterial embolization for control of obstetric hemorrhage: a five-year experience. Am J Obstet Gynecol 180(6):1454–1460

    Google Scholar 

  • Kidney DD, Nguyen AM, Ahdoot D et al (2001) Prophylactic perioperative hypogastric artery balloon occlusion in abnormal placentation. AJR Am J Roentgenol 176:1521e4

    Google Scholar 

  • Kodali BS (2010) Bloodless trilogy? Anesthesia, obstetrics and interventional radiologh for cesarean delivery. Int J Obst Anesth 19:131–132

    Article  Google Scholar 

  • Levine AB, Kuhlman K, Bonn J (1999) Placenta accreta: comparison of cases managed with and without pelvic artery balloon catheters. J Matern Fetal Med 8:173e6

    Article  Google Scholar 

  • Lauria MR, Smith RS, Treadwell MC, Comstock CH, Kirk JS, Lee W et al (1996) The use of second-trimester transvaginal sonography to predict placenta praevia. Ultrasound Obstet Gynecol 8:337–340

    Article  CAS  Google Scholar 

  • Masamoto H, Uehara H, Gibo M, Okubo E, Sakumoto K, Aoki Y (2009) Elestive use of an Aortic Baloon for Occlusion in Cesarean Hysterectomy for Placenta Previa Percreta. Gynecol Obstet Invest 67:92-95

    Google Scholar 

  • Masselli G, Brunelli R, Casciani E, Polettini E, Piccioni MG, Anceschi M et al (2008) Magnetic resonance imaging in the evaluation of placental adhesive disorders: correlation with color Doppler ultrasound. Eur Radiol 18:1292–1299

    Article  Google Scholar 

  • Mok M, Heidemann B, Dundas K et al (2008) Interventional radiology in women with suspected placenta accreta undergoing caesarean section. Int J Obstet Anesth 17:255e61. doi:10.1016/j.ijoa.2007.11.010

    Article  Google Scholar 

  • O’Rourke N, McErath T, Baum R, Camann W, Tuomala R, Stuebe A Kodali BS (2007) Cesearean Delivery In the Interventional Radiology Suite: a novel approach to haemostasis. Anesth Analg 104:1193–1194

    PubMed  Google Scholar 

  • Ojala K, Perala J, Kariniemi J et al (2005) Arterial embolization and prophylactic catheterization for the treatment for severe obstetric haemorrhage. Acta Obstet Gynecol Scand 84:1075e80. doi:10.1111/j.0001-6349.2005.00727

    Article  Google Scholar 

  • Oyelese Y, Smulian JC (2006) Placenta previa, placenta accreta, and vasa previa. Obstet Gynecol 107:927–941

    PubMed  Google Scholar 

  • Paterson-Brown S, Singh C (2010) Developing a care bundle for the management of suspected placenta accreta. Obstet Gynaecol 12:21–27

    Google Scholar 

  • Paull JD, Smith J, Williams L, Davison G, Devine T, Holt M (1995) Balloon occlusion of the abdominal aorta during desarian hysterectomy for placenta percreta. Anaesth Intens Care 23:731-734

    Google Scholar 

  • Royal College of Obstetricians and Gynaecologists (2011). Placenta praevia, placenta preavia accreta and vasa previa: diagnosis and management. Green-top guideline no. 27. RCOG, London

    Google Scholar 

  • Shih JC, Liu KL, Shyu MK (2005) Temporary balloon occlusion of the common iliac artery: new approach to bleeding control during cesarean hysterectomy for placenta percreta. Am J Obstet Gynecol 193:1756e8. doi:10.1016/j.ajog.2005.08.033

    Article  Google Scholar 

  • Sewell MF, Rosenblum D, Ehrenberg H (2006) Arterial embolus during common iliac balloon catheterization at cesarean hysterectomy. Obstet Gynecol 108:746e8. doi:10.1097/01.AOG.0000201992.80130.2c

    Article  Google Scholar 

  • Shrivastava V, Nageotte M, Major C et al (2007) Caseecontrol comparison of cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters for placenta accreta. Am J Obstet Gynecol 197:402.e1e5. doi:10.1016/j.ajog.2007.08.001

    Article  Google Scholar 

  • Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA et al, National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network (2006) Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol 107:1226–1232

    Google Scholar 

  • Smith RS, Lauria MR, Comstock CH, Treadwell MC, Kirk JS, Lee W et al (1997) Transvaginal ultrasonography for all placentas that appear to be low-lying or over the internal cervical os. Ultrasound Obstet Gynecol 9:22–24

    PubMed  Google Scholar 

  • Solheim KN, Esakoff TF, Little SE, Cheng YW, Sparks TN, Caughey AB (2011) The effect of cesarean delivery rates on the future incidence of placenta previa, placenta accreta, and maternal mortality. Matern Fetal Neonatal Med 24(11):1341–1346

    PubMed  Google Scholar 

  • Sivan E, Spira M, Achiron R et al (2010) Prophylactic pelvic artery catheterization and embolization in women with placenta accreta: can it prevent cesarean hysterectomy? Am J Perinatol 27:455e61. doi:10.1055/s-0030-1247599

    Article  Google Scholar 

  • Tan CH, Tay KH, Sheah K et al (2007) Perioperative endovascular internal iliac artery occlusion balloon placement in management of placenta accreta. AJR Am J Roentgenol 189:1158e63. doi:10.2214/AJR.07.2417

    Article  Google Scholar 

  • Thon S, McLintic A, Wagner Y (2011) Prophylactic endovascular placement of internal iliac occlusion balloon catheters in parturients with placenta accreta: a retrospective case series. Int J Obstet Anesth 20:64e70. doi:10.1016/j.ijoa.2010.08.006

    Article  Google Scholar 

  • Usta IM, Hobeika EM, Musa AA, Gabriel GE, Nassar AH (2005) Placenta previa-accreta: risk factors and complications. Am J Obstet Gynecol 193:1045–1049

    Article  Google Scholar 

  • Timmermans S, van Hof AC, Duvekot JJ (2007) Conservative management of abnormally invasive placentation. Obstet Gynecol Surv 62:529–539

    Article  Google Scholar 

  • To WKK, Leung WC (1995) Placenta previa and pervious caesarean section. Int J Gynaecol Obstet 51:25–31

    Article  CAS  Google Scholar 

  • Weeks SM, Stroud TH, Sandhu J et al (2000) Temporary balloon occlusion of the internal iliac arteries for control of hemorrhage during cesarean hysterectomy in a patient with placenta previa and placenta increta. J Vasc Interv Radiol 11:622e4

    Google Scholar 

  • Wu S, Kocherginsky M, Hibbard JU (2005) Abnormal placentation: Twenty-year analysis. Am J Obstet Gynecol 192:1458–1461

    Article  Google Scholar 

  • Yi KW, Oh MJ, Seo TS et al (2010) Prophylactic hypogastric artery ballooning in a patient with complete placenta previa and increta. J Korean Med Sci 25:651e5. doi:10.3346/jkms.2010.25.4.651

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK

    Christopher Hay & Ian Gillespie

Authors
  1. Christopher Hay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ian Gillespie
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christopher Hay .

Editor information

Editors and Affiliations

  1. Department of Radiology, Guy’s Hospital, London, UK

    John Reidy

  2. Department of Clinical Radiology, Southampton General Hospital, Southampton, UK

    Nigel Hacking

  3. Los Angeles Fibroid Treatment Center, Los Angeles, CA, USA

    Bruce McLucas

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Berlin Heidelberg

About this chapter

Cite this chapter

Hay, C., Gillespie, I. (2013). The Role of Interventional Radiology in the Management of Abnormal Placentation. In: Reidy, J., Hacking, N., McLucas, B. (eds) Radiological Interventions in Obstetrics and Gynaecology. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2013_845

Download citation

  • DOI: https://doi.org/10.1007/174_2013_845

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-27974-4

  • Online ISBN: 978-3-642-27975-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation