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Uterine embolization

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https://www.readbyqxmd.com/read/28098341/retrospective-cohort-study-of-prophylactic-intraoperative-uterine-artery-embolization-for-abnormally-invasive-placenta
#1
Yi Pan, Xin Zhou, Zhengqiang Yang, Shudong Cui, Wei De, Lizhou Sun
OBJECTIVE: To evaluate the safety and efficacy of prophylactic intraoperative uterine artery embolization (UAE) during cesarean delivery as conservative treatment for patients with abnormally invasive placenta. METHODS: A retrospective cohort study enrolled patients surgically diagnosed with abnormally invasive placenta who underwent cesarean delivery at the First Affiliated Hospital of Nanjing Medical University, Nanjing, China, between February 1, 2012, and February 28, 2015...
December 26, 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28079779/pathologically-diagnosed-placenta-accreta-and-hemorrhagic-morbidity-in-a-subsequent-pregnancy
#2
Cassandra Roeca, Sarah E Little, Daniela A Carusi
OBJECTIVE: To identify the relationship between pathologically diagnosed placenta accreta and risk of major morbidity in a subsequent pregnancy. METHODS: We conducted a retrospective cohort study of patients with pathologically diagnosed placenta accreta in an index pregnancy who returned with a subsequent pregnancy at our academic center from 2007 to 2015. Subsequent delivery outcomes included minor, major, or no morbidity. Minor morbidity included estimated blood loss 500-1,500 cc for vaginal and 1,000-1,500 cc for cesarean delivery, transfusion of one to three units of red cells, and minor surgical procedures...
January 9, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28065219/uterine-artery-embolization-for-management-of-primary-postpartum-hemorrhage-associated-with-placenta-accreta
#3
Wang Zhi-Wei, Li Xiao-Guang, Pan Jie, Zhang Xiao-Bo, Shi Hai-Feng, Yang Ning, Jin Zheng-Yu
Objective To evaluate the efficacy and safety of uterine artery embolization (UAE) in the management of primary postpartum hemorrhage associated with placenta accreta. Methods We retrospectively reviewed the medical records of patients with placenta accreta between January 2010 and August 2014. Totally 18 women (mean age 30.8±4.2 years) of primary massive postpartum hemorrhage with diagnosis of placenta accrete received treatment of UAE after delivery. Images of DSA and medical records were reviewed. Technical success was defined as control of bleeding after embolization...
November 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28063909/periprocedural-outcomes-comparing-fibroid-embolization-and-focused-ultrasound-a-randomized-controlled-trial-and-comprehensive-cohort-analysis
#4
Emily P Barnard, Ahmed M AbdElmagied, Lisa E Vaughan, Amy L Weaver, Shannon K Laughlin-Tommaso, Gina K Hesley, David A Woodrum, Vanessa L Jacoby, Maureen P Kohi, Thomas M Price, Angel Nieves, Michael J Miller, Bijan J Borah, Krzysztof R Gorny, Phyllis C Leppert, Lisa G Peterson, Elizabeth A Stewart
BACKGROUND: Uterine fibroids are a common problem for reproductive-aged women, yet little comparative effectiveness research is available to guide treatment choice. Uterine artery embolization and magnetic resonance imaging-guided focused ultrasound surgery are minimally invasive therapies approved by the United States Food and Drug Administration for treating symptomatic uterine fibroids. The Fibroid Interventions: Reducing Symptoms Today and Tomorrow study is the first randomized controlled trial to compare these 2 fibroid treatments...
January 4, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28063569/prise-en-charge-des-fibromes-ut%C3%A3-rins-en-pr%C3%A3-sence-d-une-infertilit%C3%A3-autrement-inexpliqu%C3%A3-e
#5
Belina Carranza-Mamane, Jon Havelock, Robert Hemmings
OBJECTIF: Formuler des recommandations quant à la façon optimale d'assurer la prise en charge des fibromes dans le contexte de l'infertilité. Les options habituelles et novatrices de prise en charge des fibromes seront analysées en mettant l'accent sur leur applicabilité chez les femmes qui souhaitent obtenir une grossesse. OPTIONS: La prise en charge des fibromes chez les femmes qui souhaitent obtenir une grossesse met d'abord en jeu la documentation de la présence des fibromes en question et la détermination de la probabilité que ces derniers affectent le potentiel génésique...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28052283/the-feasibility-of-conservative-management-for-morbidly-adherent-placenta-accidentally-encountered-after-vaginal-delivery
#6
Ran Cui, Junli Lu, Zhenyu Zhang, Huimin Bai
OBJECTIVE: To evaluate the feasibility of conservative management for patients with morbidly adherent placenta (MAP) accidentally encountered after term vaginal delivery. METHODS: Medical records of patients with MAP who were accidentally encountered after term vaginal delivery and treated in our hospital from January 2009 to December 2015 were retrospectively reviewed. RESULTS: A total of 8 eligible patients were included in this analysis...
January 5, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28050332/secondary-postpartum-hemorrhage-due-to-spontaneous-uterine-artery-rupture-after-normal-vaginal-delivery-managed-by-selective-arterial-embolization
#7
Mili Thakur, Henry O Adekola, Radwan Asaad, Bernard Gonik
Secondary postpartum hemorrhage due to an intraperitoneal bleed following a vaginal delivery is extremely rare. We present a case of spontaneous rupture of the uterine artery following a normal vaginal delivery with a delayed presentation, which resulted in significant morbidity. This case discusses the presentation and management of this rare obstetrical emergency. The report also discusses the role of selective arterial embolization in management of secondary postpartum hemorrhage.
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28048838/su-f-i-36-in-utero-dose-measurements-within-postmortem-subjects-for-estimating-fetal-doses-in-pregnant-patients-examined-with-pulmonary-embolism-trauma-and-appendicitis-ct
#8
I Lipnharski, N Quails, C Carranza, N Correa, S Bidari, M Bickelhaup, L Rill, M Arreola
PURPOSE: The imaging of pregnant patients is medically necessary in certain clinical situations. The purpose of this work was to directly measure uterine doses in a cadaver scanned with CT protocols commonly performed on pregnant patients in order to estimate fetal dose and assess potential risk. METHOD: One postmortem subject was scanned on a 320-slice CT scanner with standard pulmonary embolism, trauma, and appendicitis protocols. All protocols were performed with the scan parameters and ranges currently used in clinical practice...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28042408/an-unusual-cause-of-postabortal-fever-requiring-prompt-surgical-intervention-a-pyomyoma-and-its-imaging-features
#9
Rashmi Bagga, Rakhi Rai, Jasvinder Kalra, Pradip K Saha, Tulika Singh
Pyomyoma is an unusual complication of leiomyoma, occurring most commonly in the postpartum, postabortal, and post-menopausal periods. It develops due to infection in necrotic foci within leiomyoma, which is more common during pregnancy due to rapid growth, and in postmenopausal women due to vascular insufficiency. Other contributing factors are curettage, gynecological surgery, cervical stenosis, immunodeficiency, and recently, uterine artery embolization. It presents with a typical triad of sepsis, leiomyoma, and absence of any apparent source of infection...
January 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28040140/gestational-choriocarcinoma-with-renal-and-pulmonary-metastases-lacking-a-primary-uterine-origin
#10
Hao-Ming Li, Wen-Chien Hou, Yu-Ju Lai, Chien-Chang Kao, Tai-Kuang Chao, Mu-Hsien Yu, Her-Young Su
OBJECTIVE: We describe a case of gestational choriocarcinoma metastasized to the kidney and lung, which presented initially as refractory hematuria after a term pregnancy 5 years earlier. CASE REPORT: A 35-year-old woman, G2P1, with a previous history of full-term pregnancy in 2009, presented to the emergency department complaining of intermittent gross hematuria for 2 months. Abdominal computed tomography showed a suspicious arteriovenous malformation in the right kidney and a thrombus within the right renal vein...
December 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28012727/diagnosis-of-gynecological-pseudoaneurysms-and-embolization-with-cyanoacrylate
#11
M J Fernández Bermúdez, A M Fernández Martínez, L A Domitrovic, Ó Balboa Arregui
Pseudoaneurysms of the uterine artery are an uncommon cause of severe gynecological bleeding secondary to surgical manipulation of the pelvis or to instrumental delivery. The different imaging techniques are of vital importance in the diagnosis. Angiography is the technique used for confirmation and also for treatment in many cases. Endovascular treatment by embolizing the pseudoaneurysm has become established as the treatment of choice, making it possible to avoid hysterectomy in women of childbearing age...
December 21, 2016: Radiología
https://www.readbyqxmd.com/read/28004170/uterine-artery-embolization-for-retained-products-of-conception-with-marked-vascularity-a-safe-and-efficient-first-line-treatment
#12
Paul Bazeries, Francine Paisant-Thouveny, Sultan Yahya, Antoine Bouvier, Cosmina Nedelcu, Francoise Boussion, Loic Sentilhes, Serge Willoteaux, Christophe Aubé
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...
December 21, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27994261/use-of-cardiopulmonary-bypass-for-management-of-massive-air-embolism-during-hysteroscopic-metroplasty
#13
Ahmad Ali Amirghofran, Narjes Nick, Mina Amiri, Rahim Hemmati
The patient was a 32-year-old woman who presented with infertility secondary to uterine didelphys. Hysteroscopic metroplasty was chosen as the corrective surgical procedure for this anatomical defect. During the surgical repair, the patient developed a massive air embolism (MAE) leading to hypotension, arrhythmia, and cardiogenic shock. Resuscitation was started by placing the patient in the right-side up position, and emplacement of central venous catheter, but it was unsuccessful. The decision was then made to bypass the patient's cardiopulmonary system to effectively treat the MAE...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27991742/novel-approach-to-uterine-artery-pseudoaneurysm-embolization-for-delayed-post-partum-hemorrhage
#14
Ross Parker, Marc Wuerdeman, Matthew Grant, Charles Kitley
Uterine artery pseudoaneurysms (UAP) are a rare cause of post-partum hemorrhage. Conservative management is discouraged due to the risk of spontaneous hemorrhage. Intra-arterial embolization is highly successful (>90%) and offers definitive treatment. We present the case of a 27-year-old woman with significant delayed post-partum hemorrhage after cesarean section who was found to have a UAP on imaging. Her tortuous vascular anatomy and spasmodic aneurysmal neck presented technical challenges to embolization with traditional material, such as gel foam and coils...
December 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27987506/-clinical-application-and-prognostic-analysis-of-interventional-treatment-for-cesarean-scar-pregnancy
#15
J Y Lu, J P Gu, W J Xu, W S Lou, W Y Shi, T Wang, Z F Shao
OBJECTIVE: To analyze the clinical value and prognosis of cesarean scar pregnancy (CSP) treated by uterine artery embolization (UAE). METHODS: In the study, 492 cases of patients in Nanjing Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University diagnosed as CSP between January 2011 and December 2014 were chosen, of which 283 were of high-risk group and 209 of low-risk group. According to whether to take UAE, the high-risk group was subdivided into high-risk UAE group(UAE+laparoscopic group), 167 cases, and high-risk non UAE group (chemotherapy+laparoscopic group), 116 cases, while the low-risk group was subdivided into low-risk UAE group (UAE+curettage group), 113 cases, and low-risk non UAE group(chemotherapy+curettage group), 96 cases...
December 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/27979666/cesarean-scar-pregnancy-comparing-the-efficacy-and-tolerability-of-treatment-with-high-intensity-focused-ultrasound-and-uterine-artery-embolization
#16
Juhua Xiao, Zhen Shi, Jinshui Zhou, Jun Ye, Jianfang Zhu, Xin Zhou, Fang Wang, Shouhua Zhang
The aim of this study was to investigate the clinical efficacy of high-intensity focused ultrasound (HIFU) for the treatment of a cesarean scar pregnancy compared with uterine artery embolization (UAE) and intra-arterial methotrexate infusion combined with uterine curettage. In this retrospective cohort study, 31 patients were treated with HIFU (HIFU group), and 45 patients were treated with UAE (UAE group). We compared the treatment and recovery of the patients, including follow-up. After UAE treatment, serum levels of the β subunit of human chorionic gonadotropin declined significantly on the first day, and the residual lesions disappeared in 3-17 wk...
December 12, 2016: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/27966042/fertility-after-uterine-artery-embolization-for-symptomatic-multiple-fibroids-with-no-other-infertility-factors
#17
Antoine Torre, Arnaud Fauconnier, Vanessa Kahn, Olivier Limot, Laurence Bussierres, Jean Pierre Pelage
OBJECTIVES: To evaluate the fertility of women eligible for surgical multiple myomectomy, but who carefully elected a fertility-sparing uterine artery embolization (UAE). METHODS: Non-comparative open-label trial, on women ≤40 years, presenting with multiple symptomatic fibroids (at least 3, ≥3 cm), immediate pregnancy wish, and no associated infertility factor. Women had a bilateral limited UAE using tris-acryl gelatin microspheres ≥500 μm. Fertility, ovarian reserve, uterus and fibroid sizes, and quality of life questionnaires (UFS-QoL) were prospectively followed...
December 13, 2016: European Radiology
https://www.readbyqxmd.com/read/27943496/the-treatment-of-cervical-pregnancy-with-ultrasound-guided-local-methotrexate-injection
#18
Munekage Yamaguchi, Ritsuo Honda, Chimeddulam Erdenebaatar, Mahina Monsur, Tomoko Honda, Isao Sakaguchi, Yoshinori Okamura, Takashi Ohba, Hidetaka Katabuchi
OBJECTIVES: Cervical pregnancy (CP) is a rare type of ectopic pregnancy. Methotrexate (MTX) appears to be the first-line therapy for clinically stable women; however, there is still no consensus on the most appropriate treatment for this abnormal pregnancy. The aim of the present study was to investigate the efficacy of a single local MTX injection under transvaginal ultrasound guidance for the initial treatment of CP and to assess the post-treatment fertility. METHODS: We retrospectively reviewed 15 CP patients treated with local MTX injection under transvaginal ultrasonography...
December 10, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27926641/vaginal-hysterectomy-for-treatment-of-cervical-ectopic-pregnancy
#19
Roa Alammari, Renee Thibodeau, Oz Harmanli
BACKGROUND: Cervical ectopic pregnancy can lead to catastrophic hemorrhage, and may be managed conservatively with intra-amniotic methotrexate (MTX), systemic MTX, or both; surgical evacuation with or without balloon tamponade; and uterine artery embolization. However, some patients require hysterectomy, which has traditionally been performed abdominally. CASE: A 39-year-old parous woman was diagnosed with cervical ectopic pregnancy at an estimated 7 1/7 weeks of gestation...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27916062/-perioperational-management-of-gynecological-cancer-patients-with-severe-internal-medical-complications-a-serial-of-37-clinical-cases
#20
J Hu, W Q Lyu, Y L Guo, H W Wen, H Qiao, Y Qu
Objective: To evaluate the effectiveness and safety of perioperational management of gynecological cancer patients with severe internal medical complications. Methods: We collected 37 cases of gynecological cancer patients with severe internal medical complications who were hospitalized in Peking University First Hospital from Jan. 2010 to Nov. 2014. All of the cases were planned to move to ICU right after operation based on the preoperational assessment of anesthetist and physician. The median age was 69.4 years, and 25 cases (68%,25/37) of them were over 70 years old...
November 25, 2016: Zhonghua Fu Chan Ke za Zhi
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