THE ROLE OF ENDOVASCULAR INNOVATIVE METHODS – UTERINE ARTERY EMBOLIZATION, TEMPORARY BALLOON OCCLUSION OF THE COMMON ILIAC ARTERIES, TEMPORARY AORTIC BALLOON OCCLUSION IN THE TREATMENT OF PLACENTA PATHOLOGY (PLACENTA ACCRETA SPECTRUM, PLACENTA IN SITU) IN THE POSTPARTUM PERIOD

Authors

  • V. V. Tregub Medical center of the private medical enterprise «Vidar», Vinnytsia
  • O. K. Tarasiuk National Pirogov Memorial Medical University, Vinnytsia, Ukraine https://orcid.org/0000-0002-7936-5381 (unauthenticated)
  • V. A. Kondratiuk National Institute of Surgery and Transplantology of the National Academy of Sciences of Ukraine named after O. O. Shalimov
  • I. V. Altman Scientific and practical center of Endovascular X-Ray Surgery of the National Academy of Sciences of Ukraine, State Institution «Institute of Neurosurgery named after acad. A. P. Romodanov»

DOI:

https://doi.org/10.11603/24116-4944.2025.1.15058

Keywords:

uterine artery embolization, placental pathology, endovascular methods

Abstract

The aim of the study – to introduce innovative endovascular methods in the treatment of placental adhesion pathology, with a description of a clinical case of bilateral uterine artery embolization in this pathology.

Materials and Methods. A clinical case of uterine artery embolization in the postpartum period in placental adhesion patho­logy is described.

Results and Discussion. As a result of the treatment, there was no blood flow in the placenta, its resorption and separation on the 46th day after uterine artery embolization, which was confirmed by a control study.

Conclusions. The use of uterine artery embolization in a patient with placental adhesion pathology in the postpartum period made it possible to prevent hysterectomy and have the opportunity to perform fertile function in the future.

Author Biographies

  • V. V. Tregub, Medical center of the private medical enterprise «Vidar», Vinnytsia

    director of the medical center of PMС «Vidar»

  • O. K. Tarasiuk, National Pirogov Memorial Medical University, Vinnytsia, Ukraine

    Ph.D., Associate professor of the Department of Obstetrics and Gynecology № 1

  • V. A. Kondratiuk, National Institute of Surgery and Transplantology of the National Academy of Sciences of Ukraine named after O. O. Shalimov

    Doctor of Medicine, senior researcher

  • I. V. Altman, Scientific and practical center of Endovascular X-Ray Surgery of the National Academy of Sciences of Ukraine, State Institution «Institute of Neurosurgery named after acad. A. P. Romodanov»

    Ph.D., senior researcher

References

1. Wu, S., Kocherginski, M., & Hibbard, J. U. (2005). Abnormal placentation: twenty-year analysis. American Journal of Obstetrics and Gynecology, 192, 1458–1461. https://doi.org/10.1016/j.ajog.2004.12.074

2. Afshar, Y., Yin, O., & Jeong, A. (2024). Placenta accreta spectrum disorder at single-cell resolution. American Journal of Obstetrics and Gynecology, 230(4). https://doi.org/10.1016/j.ajog.2023.10.026

3. Paul, J. D., & Smith, J. (1995). Balloon occlusion of the abdominal aorta during caesarean hysterectomy for placenta percreta. Anaesthesia and Intensive Care, 23(6), 731–734. https://doi.org/10.1177/0310057X9502300616

4. Parashchuk, Y. S., Kalinovska, O. I., & Safonov, R. A. (2023). Kombinovane endovaskulyarne ta khimioterapevtychne likuvannya patsiyentky z istynnym pryroshchennyam platsenty [Combined endovascular and chemotherapeutic treatment of a patient with true placenta accreta]. In Dosvid zastosuvannya endovaskulyarnykh operatsiy v akushersko-hinekolohichniy praktytsi Ukrayiny: zbirnyk naukovykh pratsʹ (pp. 358–366).

5. Trehub, V. V., Tarasyuk, V. I., Tarasyuk, O. K., Altman, I. V., & Kondratyuk, V. A. (2023). Vykorystannya EMA v yakosti endovaskulyarnoho metodu viddilennya chastyny platsenty v pislyapolohovomu periodi [Use of uterine artery embolization as an endovascular method for retained placental tissue in the postpartum period]. In Dosvid zastosuvannya endovaskulyarnykh operatsiy v akushersko-hinekolohichniy praktytsi Ukrayiny.

6. Cali, G., Forlani, F., Giambanco, L., Amico, M. L., Vallone, M., & Puccio, G. (2014). Prophylactic use of intravascular balloon catheters in women with placenta accreta, increta and percreta. European Journal of Obstetrics & Gynecology and Reproductive Biology, 179, 36–41. https://doi.org/10.1016/j.ejogrb.2014.05.019

7. Ballas, J., Hull, A. D., Saenz, C., Warshak, C. R., Roberts, A. C., & Resnik, R. R. (2012). Preoperative intravascular balloon catheters and surgical outcomes in pregnancies complicated by placenta accreta: A management paradox. American Journal of Obstetrics and Gynecology, 207(3), 216.e1–216.e5. https://doi.org/10.1016/j.ajog.2012.06.007

8. Holyanovskyy, O. V., & Vereshchahin, S. V. (2018). Innovatsiyi rozrodzhennya vahitnykh zhinok z anomalʹno invazyvnoyu platsentoyu: placenta percreta [Innovations in delivery of women with abnormally invasive placenta: Placenta percreta]. Women's Health, 6, 19–24. doi 10.15574/HW.2018.132.19

9. Hrizhymalskyy, Y. V., Shaldun, D. R., Harha, A. Y., & Tsivyna, O. M. (2018). Suchasnyy Patient Blood Management na prykladi Placenta Percreta [Modern Patient Blood Management using Placenta Percreta as an example]. Medical Aspects of Women's Health, 7–8, 11–15.

10. Kolisnyk, V. O., Burlak, O. S., Ryazantsev, I. I., & Petrovykh, S. I. (2023). Zastosuvannya endovaskulyarnoyi balonnoyi oklyuziyi aorty u vahitnoyi z Placenta Accreta Spectrum [The use of endovascular balloon occlusion of the aorta in a pregnant woman with Placenta Accreta Spectrum]. In Dosvid zastosuvannya endovaskulyarnykh operatsiy v akushersko-hinekolohichniy praktytsi Ukrayiny.

11. Sentilhes, L., Ambroselli, C., Kayem, G., Provansal, M., Fernandez, H., & Perrotin, F. (2010). Maternal outcome after conservative treatment of placenta accreta. Obstetrics & Gynecology, 115(3), 526–534. https://doi.org/10.1097/AOG.0b013e3181d066d4

12. Fox, K. A., Shamshirsaz, A. A., Carusi, D., Secord, A. A., & Lee, P. (2015). Conservative management of morbidly adherent placenta: Expert review. American Journal of Obstetrics and Gynecology, 213(6), 755–760. https://doi.org/10.1016/j.ajog.2015.05.019

13. Bodner, L. J., Nosher, J. L., Gribbin, C., Siegel, R. L., Beale, S., & Scorza, W. (2006). Balloon-assisted occlusion of the internal iliac arteries in patients with placenta accreta/percreta. CardioVascular and Interventional Radiology, 29(3), 354–361. https://doi.org/10.1007/s00270-005-0176-3

14. Shih, J. C., Liu, K. L., & Shyu, M. K. (2005). Temporary balloon occlusion of the common iliac artery: New approach to bleeding control during cesarean hysterectomy for placenta percreta. American Journal of Obstetrics and Gynecology, 193(5), 1756–1758. https://doi.org/10.1016/j.ajog.2005.07.070

15. Sentilhes, L., Kayem, G., Ambroselli, C., Provansal, M., Fernandez, H., & Perrotin, F. (2010). Fertility and pregnancy outcomes following conservative treatment for placenta accreta. Human Reproduction, 25(11), 2803–2810. https://doi.org/10.1093/humrep/deq239

16. Kabiri, D., Hants, Y., Shanwetter, N., Simons, M., & Weiniger, C. F. (2014). Outcomes of subsequent pregnancies after conservative treatment for placenta accreta. International Journal of Gynecology & Obstetrics, 127(3), 206–210. https://doi.org/10.1016/j.ijgo.2014.06.024

17. American College of Obstetricians and Gynecologists. (2011). ACOG Practice Bulletin No. 120: Use of prophylactic antibiotics in labor and delivery. Obstetrics & Gynecology, 117(6), 1472–1483. https://doi.org/10.1097/AOG.0b013e3182238c31

18. American College of Obstetricians and Gynecologists. (2018). Obstetric Care Consensus No. 7: Placenta accreta spectrum. Obstetrics & Gynecology, 132(6), e259–e275. https://doi.org/10.1097/AOG.0000000000002983

19. Cahill, A. G., Beigi, R., Heine, R. P., Silver, R. M., & Wax, J. R. (2018). Placenta accreta spectrum. American Journal of Obstetrics and Gynecology, 219(6), B2–B16. https://doi.org/10.1016/j.ajog.2018.09.042

20. Silver, R. M., & Branch, D. W. (2018). Placenta accreta spectrum. New England Journal of Medicine, 378(16), 1529–1536. https://doi.org/10.1056/NEJMcp1709324

21. Ministry of Health of Ukraine. (2023). Pro zatverdzhennya Standartiv medychnoyi dopomohy «Leyomioma matky»: Nakaz MOZ Ukrayiny vid 25.01.2023 № 147 [On approval of the Standards of Medical Care "Uterine Leiomyoma": Order of the Ministry of Health of Ukraine No. 147 of January 25, 2023].

Published

2025-06-12

Issue

Section

OBSTETRICS AND GYNECOLOGY

How to Cite

THE ROLE OF ENDOVASCULAR INNOVATIVE METHODS – UTERINE ARTERY EMBOLIZATION, TEMPORARY BALLOON OCCLUSION OF THE COMMON ILIAC ARTERIES, TEMPORARY AORTIC BALLOON OCCLUSION IN THE TREATMENT OF PLACENTA PATHOLOGY (PLACENTA ACCRETA SPECTRUM, PLACENTA IN SITU) IN THE POSTPARTUM PERIOD. (2025). Actual Problems of Pediatrics, Obstetrics and Gynecology, 1, 5-12. https://doi.org/10.11603/24116-4944.2025.1.15058