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Soyer P, Barat M, Loffroy R, et al. The role of interventional radiology in the management of abnormally invasive placenta: a systematic review of current evidences. Quant Imaging Med Surg. 2020;10(6):1370-1391doi: 10.21037/qims-20-548.
Soyer, P., Barat, M., Loffroy, R., Barral, M., Dautry, R., Vidal, V., Pellerin, O., Cornelis, F., Kohi, M. P., & Dohan, A. (2020). The role of interventional radiology in the management of abnormally invasive placenta: a systematic review of current evidences. Quantitative imaging in medicine and surgery, 10(6), 1370-1391. https://doi.org/10.21037/qims-20-548
Soyer, Philippe, et al. "The role of interventional radiology in the management of abnormally invasive placenta: a systematic review of current evidences." Quantitative imaging in medicine and surgery vol. 10,6 (2020): 1370-1391. doi: https://doi.org/10.21037/qims-20-548
Soyer P, Barat M, Loffroy R, Barral M, Dautry R, Vidal V, Pellerin O, Cornelis F, Kohi MP, Dohan A. The role of interventional radiology in the management of abnormally invasive placenta: a systematic review of current evidences. Quant Imaging Med Surg. 2020 Jun;10(6):1370-1391. doi: 10.21037/qims-20-548. PMID: 32550143; PMCID: PMC7276355.
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Quant Imaging Med Surg. 2020 Jun;10(6):1370-1391. doi: 10.21037/qims-20-548.

The role of interventional radiology in the management of abnormally invasive placenta: a systematic review of current evidences.

Quantitative imaging in medicine and surgery

Philippe Soyer, Maxime Barat, Romaric Loffroy, Matthias Barral, Raphael Dautry, Vincent Vidal, Olivier Pellerin, Francois Cornelis, Maureen P Kohi, Anthony Dohan

Affiliations

  1. Department of Radiology, Hopital Cochin, Assistance Publique - Hopitaux de Paris, Paris, France.
  2. Université de Paris, Descartes-Paris 5, Paris, France.
  3. Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, UFR des Sciences de Santé, Université de Bourgogne/Franche-Comté, Dijon, France.
  4. Department of Radiology, Hopital Tenon, Assistance Publique - Hopitaux de Paris, Paris, France.
  5. Sorbonne University, Paris, France.
  6. Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, LIIE, CERIMED Aix Marseille Univ, Marseille, France.
  7. Department of Interventional Radiology, Hopital Européen Georges Pompidou, Assistance Publique-Hopitaux de Paris, Paris, France.
  8. Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.

PMID: 32550143 PMCID: PMC7276355 DOI: 10.21037/qims-20-548

Abstract

Abnormally invasive placenta (AIP) is a potentially severe condition. To date, arterial embolization in women with postpartum hemorrhage due to AIP is the treatment option for which highest degrees of evidence are available. However, other techniques have been tested, including prophylactic catheter placement, balloon occlusion of the iliac arteries and abdominal aorta balloon occlusion. In this systematic review, we provide an overview of the currently reported interventional radiology procedures that are used for the treatment of postpartum hemorrhage due to AIP and suggest recommendations based on current evidences. Owing to a high rate of adverse events, prophylactic occlusion of internal iliac arteries should be used with caution and applied when the endpoint is hysterectomy. On the opposite, when a conservative management is considered to preserve future fertility, uterine artery embolization should be the preferred option as it is associated with a hysterectomy rate of 15.5% compared to 76.5% with prophylactic balloon occlusion of the internal iliac arteries and does not result in fetal irradiation. Limited data are available regarding the application of systematic prophylactic embolization and no comparative studies with arterial embolization are available.

2020 Quantitative Imaging in Medicine and Surgery. All rights reserved.

Keywords: Postpartum hemorrhage; balloon occlusion; embolization; interventional radiology; placenta; therapeutic

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/qims-20-548). RL serves as an unpaid Deputy Editor of Quantitative Imaging

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