CLINICAL INVESTIGATION ARTERIAL INTERVENTIONS Prophylactic Uterine Artery Embolization Assisted Cesarean Section for the Prevention of Intrapartum Hemorrhage in High-Risk Patients

Purpose To evaluate the safety and efficacy of prophy-lactic uterine artery embolization (UAE)-assisted cesarean section for the prevention of intrapartum hemorrhage. Materials and Methods Twelve consecutive pregnant women (mean age 31 years; range 25–38) with uterine scarring and placenta previa and/or placenta accreta underwent UAE in conjunction with cesarean section to prevent intrapartum hemorrhage. For UAE, the left uterine artery was catheterized prophylactically under fluoroscopic guidance before the cesarean section incision was made. After the infant had been delivered, bilateral UAE was performed with the placenta still in situ. After successful bilateral UAE, the placenta was detached from the uterine wall. Results Technical success was achieved in all 12 cases. Ten patients retained their uterus, and the other 2 under-went hysterectomy. The mean operative blood loss was 1,391 mL (range 600–3,600 mL). The total mean fluoros-copy time and mean absorbed dose (air kerma) were 9 mi