Preliminary experience in uterine artery embolization for second trimester pregnancy induced labor with complete placenta previa, placenta implantation, and pernicious placenta previa.

OBJECTIVE

To explore the application of uterine artery embolization (UAE) in complete placenta previa, placenta implantation, and pernicious placenta previa during second trimester pregnancy induced labor.

METHODS

From April 2013 to April 2014, the present hospital admitted 12 cases of second-trimester complete placenta previa, placenta implantation, and pernicious placenta previa. Six of 12 cases at first were given UAE before cesarean section or labor induction. The other six cases, which were introduced into the present hospital after a failed embolization, underwent UAE, followed by hysteroscopy or curettage or laparotomy.

RESULTS

None of the 12 patients underwent hysterectomy. The average blood loss of six patients with UAE was 383 ml and the average hospitalization was 8.66 days. While the remaining six patients without embolization in advance experienced 1,533 ml mean blood loss and 18 days in average stay. Among 12 patients, seven reported abdominal pain following embolization, four had a fever, and two had nausea and vomiting. Nine patients were followed-up and the menstrual cycles of seven returned to normal in one+ month, one in two+ months, and one suffered amenorrhea. Among the same nine patients, six menstruated regularly, two had menstrual disorders, and one had amenorrhea. No serious short- and long-term complications were observed.

CONCLUSIONS

UAE is the safe method to avoid serious bleeding due to complete placenta previa, placenta implantation, and pernicious placenta previa with second-trimester pregnancy termination.