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Serial Uterine Artery Embolization for the Treatment of Placenta Percreta in the First Trimester: A Case Report
John DeMeritt1, Ethan Wajswol2, Anoop Wattamwar3
1Department of Radiology, Hackensack University Medical Center, 30 Prospect Avenue, Hackensack, NJ, 07601, USA. jsdemeritt@aol.com.
Abstract:
Two patients with placenta percreta underwent uterine artery embolization (UAE) for abnormally invasive placenta (AIP) in the first trimester. Patient 1 had a 9-week cervical ectopic, while Patient 2 had a 9-week cesarean scar pregnancy. Elective termination of pregnancy was performed in both patients. UAE was performed with tris-acryl gelatin microspheres as well as gelfoam until stasis and was repeated in cases of revascularization. Both patients were followed with US/MRI/MRA scans and β-hCG levels. Revascularization occurred in both patients following UAE, requiring multiple embolizations to achieve complete placental involution. Serial bland UAE may be an effective technique in the treatment of first-trimester AIP, with the distinct advantage of maintaining a patient's fertility.
Level Of Evidence:
Level IV.
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