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CardioVascular and Interventional Radiology

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21.12.2016 | Clinical Investigation

Uterine Artery Embolization for Retained Products of Conception with Marked Vascularity: A Safe and Efficient First-Line Treatment

verfasst von: Paul Bazeries, Francine Paisant-Thouveny, Sultan Yahya, Antoine Bouvier, Cosmina Nedelcu, Francoise Boussion, Loic Sentilhes, Serge Willoteaux, Christophe Aubé

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 4/2017

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Abstract

Objective

To report our clinical practice regarding a case series of retained products of conception (RPOC) with marked vascularity (MV) managed with selective uterine artery embolization (UAE) as first-line treatment.

Methods

This was a monocentric, retrospective study of 31 consecutive cases of RPOC with MV diagnosed by Doppler ultrasound in the context of postpartum/postabortal bleeding. The primary outcome was the absence of rebleeding following embolization.

Results

RPOC with MV occurred after abortion in 27 out of 31 patients (87%). The time elapsed between delivery/abortion and UAE ranged from 1 to 210 days (mean 55.7 ± 45 days). Primary clinical success was achieved in 23 women (74.2%) following a single embolization. In total, 27 out of 31 women (87%) had been exclusively managed by UAE with conservative success. Although procedural success was achieved in this number, six women had a further procedure to evacuate RPOC despite procedural success. Large uterine arteriovenous (AV) shunts associated with RPOC were observed in five cases (16.1%), among which two were successfully treated after a single UAE and one after two UAEs, while hysterectomy was performed in the last two cases despite two and three UAE procedures respectively. RPOC was histologically proven in ten cases (32.2%) including four out of five cases of uterine AV shunt.

Conclusion

RPOC with MV can present with large uterine AV shunt, particularly in case of late management. Uterine artery embolization is an effective and safe first-line treatment, and should be evaluated for this indication in larger prospective trials.

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Titel: Uterine Artery Embolization for Retained Products of Conception with Marked Vascularity: A Safe and Efficient First-Line Treatment
verfasst von: Paul Bazeries
Francine Paisant-Thouveny
Sultan Yahya
Antoine Bouvier
Cosmina Nedelcu
Francoise Boussion
Loic Sentilhes
Serge Willoteaux
Christophe Aubé
Publikationsdatum: 21.12.2016
Verlag: Springer US
Erschienen in: CardioVascular and Interventional Radiology / Ausgabe 4/2017
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-016-1543-7

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Uterine Artery Embolization for Retained Products of Conception with Marked Vascularity: A Safe and Efficient First-Line Treatment