Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 5/2010

01.05.2010 | Original Article

Computed tomographic angiography in diagnosis and management of placental polyp with neovascularization

verfasst von: Akihiro Takeda, Kazuyuki Koyama, Sanae Imoto, Masahiko Mori, Kotaro Sakai, Hiromi Nakamura

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 5/2010

Einloggen, um Zugang zu erhalten

Abstract

Objective

To evaluate the neovascularization in placental polyp tissue by computed tomographic angiography and to determine the need for uterine artery embolization before hysteroscopic resection.

Study design

Seventeen consecutive women with suspected placental polyp were enrolled in this retrospective study. Neovascularization in placental polyp tissue was assessed by computed tomographic angiography. Cases with neovascularization were treated by hysteroscopic resection with preoperative uterine artery embolization, while cases without neovascularization were treated by hysteroscopic resection alone.

Results

Of 17 patients with suspected placental polyp after abortion or parturition, nine patients were diagnosed to have placental polyp with prominent neovascularization by computed tomographic angiography, and were treated by uterine artery embolization followed by hysteroscopic resection. Two patients subsequently conceived after conservative management.

Conclusions

After precise evaluation of neovascularization by computed tomographic angiography, hysteroscopic resection with preoperative uterine artery embolization is an effective minimally invasive procedure to conservatively treat placental polyp with prominent neovascularization.
Literatur
1.
Zurück zum Zitat Swan RW, Woodruff JD (1969) Retained products of conception: histologic viability of placental polyps. Obstet Gynecol 34:506–514PubMed Swan RW, Woodruff JD (1969) Retained products of conception: histologic viability of placental polyps. Obstet Gynecol 34:506–514PubMed
2.
Zurück zum Zitat Dyer I, Bradburn DM (1971) An inquiry into the etiology of placental polyps. Am J Obstet Gynecol 109:858–867PubMed Dyer I, Bradburn DM (1971) An inquiry into the etiology of placental polyps. Am J Obstet Gynecol 109:858–867PubMed
3.
Zurück zum Zitat Kurachi H, Maeda T, Murakami T, Tsuda K, Sakata M, Nakamura H, Miyake A (1995) MRI of placental polyps. J Comput Assist Tomogr 19:444–448CrossRefPubMed Kurachi H, Maeda T, Murakami T, Tsuda K, Sakata M, Nakamura H, Miyake A (1995) MRI of placental polyps. J Comput Assist Tomogr 19:444–448CrossRefPubMed
4.
Zurück zum Zitat Noonan JB, Coakley FV, Qayyum A, Yeh BM, Wu L, Chen L (2003) MR imaging of retained products of conception. Am J Roentgenol 181:435–439 Noonan JB, Coakley FV, Qayyum A, Yeh BM, Wu L, Chen L (2003) MR imaging of retained products of conception. Am J Roentgenol 181:435–439
5.
Zurück zum Zitat Sadan O, Golan A, Girtler O, Lurie S, Debby A, Sagiv R, Evron S, Glezerman M (2004) Role of sonography in the diagnosis of retained products of conception. J Ultrasound Med 23:371–374PubMed Sadan O, Golan A, Girtler O, Lurie S, Debby A, Sagiv R, Evron S, Glezerman M (2004) Role of sonography in the diagnosis of retained products of conception. J Ultrasound Med 23:371–374PubMed
6.
Zurück zum Zitat Durfee SM, Frates MC, Luong A, Benson CB (2005) The sonographic and color Doppler features of retained products of conception. J Ultrasound Med 24:1181–1186PubMed Durfee SM, Frates MC, Luong A, Benson CB (2005) The sonographic and color Doppler features of retained products of conception. J Ultrasound Med 24:1181–1186PubMed
7.
Zurück zum Zitat Greenberg JA, Miner JD, O’Horo SK (2006) Uterine artery embolization and hysteroscopic resection to treat retained placenta accreta: a case report. J Minim Invasive Gynecol 13:342–344CrossRefPubMed Greenberg JA, Miner JD, O’Horo SK (2006) Uterine artery embolization and hysteroscopic resection to treat retained placenta accreta: a case report. J Minim Invasive Gynecol 13:342–344CrossRefPubMed
8.
Zurück zum Zitat Hatfield JL, Brumsted JR, Cooper BC (2006) Conservative treatment of placenta accreta. J Minim Invasive Gynecol 13:510–513CrossRefPubMed Hatfield JL, Brumsted JR, Cooper BC (2006) Conservative treatment of placenta accreta. J Minim Invasive Gynecol 13:510–513CrossRefPubMed
9.
Zurück zum Zitat Takeuchi K, Sugimoto M, Kitao K, Yoshida S, Maruo T (2007) Pregnancy outcome of uterine arterial embolization followed by selective hysteroscopic removal of a placental polyp. Acta Obstet Gynecol Scand 86:22–25CrossRefPubMed Takeuchi K, Sugimoto M, Kitao K, Yoshida S, Maruo T (2007) Pregnancy outcome of uterine arterial embolization followed by selective hysteroscopic removal of a placental polyp. Acta Obstet Gynecol Scand 86:22–25CrossRefPubMed
10.
Zurück zum Zitat Jiménez JS, Gonzalez C, Alvarez C, Muñoz L, Pérez C, Muñoz JL (2009) Conservative management of retained trophoblastic tissue and placental polyp with diagnostic ambulatory hysteroscopy. Eur J Obstet Gynecol Reprod Biol. doi:10.1016/j.ejogrb.2009.04.001 (in press) Jiménez JS, Gonzalez C, Alvarez C, Muñoz L, Pérez C, Muñoz JL (2009) Conservative management of retained trophoblastic tissue and placental polyp with diagnostic ambulatory hysteroscopy. Eur J Obstet Gynecol Reprod Biol. doi:10.​1016/​j.​ejogrb.​2009.​04.​001 (in press)
11.
Zurück zum Zitat Takeda A, Koyama K, Mori M, Sakai K, Mitsui T, Nakamura H (2008) Diagnostic computed tomographic angiography and therapeutic emergent transcatheter arterial embolization for management of postoperative hemorrhage after gynecologic laparoscopic surgery. J Minim Invasive Gynecol 15:332–341CrossRefPubMed Takeda A, Koyama K, Mori M, Sakai K, Mitsui T, Nakamura H (2008) Diagnostic computed tomographic angiography and therapeutic emergent transcatheter arterial embolization for management of postoperative hemorrhage after gynecologic laparoscopic surgery. J Minim Invasive Gynecol 15:332–341CrossRefPubMed
12.
Zurück zum Zitat Takeda A, Koyama K, Imoto S, Mori M, Sakai K, Nakamura H. Progressive formation of uterine arteriovenous fistula after laparoscopic-assisted myomectomy Arch Gynecol Obstet. doi: 10.1007/s00404-009-0981-8 (in press) Takeda A, Koyama K, Imoto S, Mori M, Sakai K, Nakamura H. Progressive formation of uterine arteriovenous fistula after laparoscopic-assisted myomectomy Arch Gynecol Obstet. doi: 10.​1007/​s00404-009-0981-8 (in press)
13.
Zurück zum Zitat Takeda A, Manabe S, Hosono S, Nakamura H (2004) Preoperative evaluation of submucosal myoma by virtual hysteroscopy. J Am Assoc Gynecol Laparosc 11:404–409CrossRefPubMed Takeda A, Manabe S, Hosono S, Nakamura H (2004) Preoperative evaluation of submucosal myoma by virtual hysteroscopy. J Am Assoc Gynecol Laparosc 11:404–409CrossRefPubMed
14.
Zurück zum Zitat Kido A, Togashi K, Koyama T, Ito H, Tatsumi K, Fujii S, Konishi J (2003) Retained products of conception masquerading as acquired arteriovenous malformation. J Comput Assist Tomogr 27:88–92CrossRefPubMed Kido A, Togashi K, Koyama T, Ito H, Tatsumi K, Fujii S, Konishi J (2003) Retained products of conception masquerading as acquired arteriovenous malformation. J Comput Assist Tomogr 27:88–92CrossRefPubMed
Metadaten
Titel
Computed tomographic angiography in diagnosis and management of placental polyp with neovascularization
verfasst von
Akihiro Takeda
Kazuyuki Koyama
Sanae Imoto
Masahiko Mori
Kotaro Sakai
Hiromi Nakamura
Publikationsdatum
01.05.2010
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 5/2010
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-009-1161-6

Weitere Artikel der Ausgabe 5/2010

Archives of Gynecology and Obstetrics 5/2010 Zur Ausgabe

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

26.04.2024 Hirsutismus Nachrichten

Laser- und Lichtbehandlungen können bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) den übermäßigen Haarwuchs verringern und das Wohlbefinden verbessern – bei alleiniger Anwendung oder in Kombination mit Medikamenten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

22.04.2024 DGIM 2024 Kongressbericht

Durch die Häufung nach der COVID-19-Pandemie sind Infektionen mit dem Respiratorischen Synzytial-Virus (RSV) in den Fokus gerückt. Fachgesellschaften empfehlen eine Impfung inzwischen nicht nur für Säuglinge und Kleinkinder.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.