Role of interventional radiology in management of placenta accreta
Nehal Sayed Mohamed Zeidan;
Abstract
Placenta accreta (PA) encompasses various types of abnormal placentation in which chorionic villi attach directly to or invade the myometrium.
There is high risk for maternal mortality in postpartum hemorrhage due to placenta accreta.
The placental examination should be routinely done in antenatal examination to detect any placental invasion abnormalities as placental invasion abnormality is important to be recognized owing to the potential for maternal morbidity and mortality.
Non invasive techniques such as ultrasonography (US), Color and power Doppler and magnetic resonance imaging (MR) that do not use ionizing radiation are preferred.
Ultrasonography is the primary modality of obstetric placental imaging because of its rapid availability, portability, and low cost. Its limitations include posterior placental positioning and patient body habitus. MRI, on the other hand, is excellent in the evaluation of the placenta, irrespective of its anatomical position within the uterus.
Color and power Doppler techniques permit direct visualization of placental vascularity, allowing assessment of both the uteroplacental and fetoplacental circulations
MRI is an excellent tool for the staging and topographic evaluation of placenta accrete as it can provide essential information about underlying pathologies.
The interven¬tional radiologist carries a major responsibility for the preventive management of hemorrhage due to placenta accreta diagnosed antepartum and is thus a crucial member of the delivery team.
Before delivery, bilateral internal iliac artery balloon occlusion is performed
The balloon on both catheters may be inflated intermittently during the surgical procedure or may be left inflated if excessive bleeding occurs, the catheters (with balloons deflated) maybe left in place for a short period after surgery, to expedite angiography and embolization in cases of postpartum hemorrhage.
There is high risk for maternal mortality in postpartum hemorrhage due to placenta accreta.
The placental examination should be routinely done in antenatal examination to detect any placental invasion abnormalities as placental invasion abnormality is important to be recognized owing to the potential for maternal morbidity and mortality.
Non invasive techniques such as ultrasonography (US), Color and power Doppler and magnetic resonance imaging (MR) that do not use ionizing radiation are preferred.
Ultrasonography is the primary modality of obstetric placental imaging because of its rapid availability, portability, and low cost. Its limitations include posterior placental positioning and patient body habitus. MRI, on the other hand, is excellent in the evaluation of the placenta, irrespective of its anatomical position within the uterus.
Color and power Doppler techniques permit direct visualization of placental vascularity, allowing assessment of both the uteroplacental and fetoplacental circulations
MRI is an excellent tool for the staging and topographic evaluation of placenta accrete as it can provide essential information about underlying pathologies.
The interven¬tional radiologist carries a major responsibility for the preventive management of hemorrhage due to placenta accreta diagnosed antepartum and is thus a crucial member of the delivery team.
Before delivery, bilateral internal iliac artery balloon occlusion is performed
The balloon on both catheters may be inflated intermittently during the surgical procedure or may be left inflated if excessive bleeding occurs, the catheters (with balloons deflated) maybe left in place for a short period after surgery, to expedite angiography and embolization in cases of postpartum hemorrhage.
Other data
| Title | Role of interventional radiology in management of placenta accreta | Other Titles | دور الاشعه التداخليه في علاج المشيمه الملتصقه | Authors | Nehal Sayed Mohamed Zeidan | Issue Date | 2015 |
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