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Placenta Accreta: A Case Report on the Role of Interventional Radiology
Mafalda Machado1, Teresa Dionísio2, Diogo Rocha2
1Radiology, Centro Hospitalar Universitário do Algarve, Faro, PRT.
Cureus
|November 29, 2023
Summary
Placenta accreta spectrum disorder can cause severe hemorrhage, often leading to hysterectomy. This case highlights successful uterus preservation using prophylactic balloon-assisted occlusion during cesarean delivery.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Interventional Radiology
Background:
- Placenta accreta spectrum (PAS) disorders are a significant cause of postpartum hemorrhage and necessitate hysterectomy in many cases.
- International guidelines recommend planned cesarean hysterectomy for PAS, but uterus-preserving strategies are increasingly explored.
- Minimally invasive techniques, like prophylactic balloon-assisted occlusion, are emerging as options for bleeding reduction.
Observation:
- A 40-year-old woman with a history of cesarean delivery presented with second-trimester vaginal bleeding.
- Magnetic resonance imaging revealed placenta previa with suspected placenta accreta.
- A multidisciplinary team, including an interventional radiologist, managed the case.
Findings:
- A planned cesarean delivery was performed at 36 weeks gestation.
- Prophylactic balloon-assisted occlusion was successfully implemented prior to delivery.
- This minimally invasive strategy significantly minimized intraoperative blood loss.
Implications:
- Successful uterus preservation was achieved in a patient with suspected placenta accreta spectrum disorder.
- Prophylactic balloon-assisted occlusion demonstrates potential as an effective adjunct in managing PAS, reducing hemorrhage.
- This approach offers a viable alternative to hysterectomy, preserving reproductive potential in selected cases.
