Use of uterine artery embolization to prevent peripartum hemorrhage of placental abruption with fetal demise & severe DIC

Article type: Case Report

Authors: Latif, E.^a | Adam, S.^{b; *} | Rungruang, B.^a | Al-Hendy, A.^a | Diamond, M.P.^a | Rotem, E.^a | Cannell, J.^a | Browne, P.C.^a

Affiliations: [a] Department of Obstetrics and Gynecology, Georgia Regents University School of Medicine, Augusta, GA, USA | [b] Deptarment of Obstetrics and Gynecology, Mercer University Medical Center, Macon, GA, USA. | [c] Department of Obstetrics and Gynecology, Naviceent Health Center, Mercert University, Macon, GA, USA

Correspondence: [*] Address for Correspondence: Sarah Adam, MD, Deptarment of Obstetrics and Gynecology, Mercer University Medical Center, Macon, GA, USA. E-mail: sarahadam2222@gmail.com.

Abstract: Uterine artery embolization (UAE) is typically not indicated in the pre-operative management of pregnancies with a live fetus, because risk of fetal death from reduced uteroplacental blood flow. However, pre-operative UAE in pregnancies with a fetal demise poses no fetal risk, and may offer maternal benefits. Patients with placental abruption resulting in fetal demise are at high-risk for developing disseminated intravascular coagulation (DIC), which could have devastating complications such as peri-operative hemorrhage and death. This case report describes the first successful execution of a pre-operative UAE that effectively prevented antepartum and postpartum hemorrhage in a patient with DIC secondary to a placental abruption and recent fetal demise.

Keywords: Uterine artery embolization (UAE), antepartum hemorrhage, post-partum hemorrhage, transcatheter arterial embolization, disseminated intravascular coagulation, placental abruption

DOI: 10.3233/NPM-16915108

Journal: Journal of Neonatal-Perinatal Medicine, vol. 9, no. 3, pp. 325-331, 2016