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C-2437 - Prophylactic occlusion balloon placement to prevent hemorrhage in pregnant women with invasive placentation

M. Jarzabek1, L. Mailli1, A. Belli1, G. Bonera2, V. Patsiogiannis1, L. Ratnam1; 1 London/UK 2 Bescia/IT Type: Educational Exhibit
Area of Interests: Interventional vascular, Genital / Reproductive system female, Pelvis
Imaging Techniques: Fluoroscopy, Catheter arteriography, CT-Angiography
Procedures: Complications, Catheters, Balloon occlusion
Special Focuses: Acute, Hemorrhage, Obstetrics
Please note: This poster is part of the session VoE 43 - Interventional on Thursday, March 2, 14:00 - 15:00 Add poster to my schedule In your schedule (remove)

Learning objectives:  To outline the indications and pre procedure arrangements for prophylactic occlusion balloon catheterization (POBC) in pregnant women with abnormal placentation.    To be familiar with the technical aspects and the protocol of an effective procedure.    To be aware of t[...]

Background:  The increased incidence of cesarean deliveries 1:2000 to 1:533 ⇒ greater prevalence of invasive placentation [1].    Morbidly adherent placenta ⇒ leading cause of obstetric haemorrhage and peripartum hysterectomy [2].    Improved placenta diagnostic process ⇒ [...]

Findings and procedure details: Diagnosis of Invasive Placentation   History of c-section, myomectomy, uterine curettage, endometritis Ultrasound [8] Large lacunae with ‘Moth eaten’ appearance  Loss of hypoechogenic myometrium  Thinning of the myometrium < 1mm  The ‘Dash sign’ suggesting bladder in[...]

Conclusion: Valuable and effective adjunct in management of high risk pregnancy.        Multidisciplinary team co-operation between Interventional Radiology, Obstetric and Anaesthetic teams is essential.       Detailed, robust protocols must be in place.  

Personal information: The presentation has been prepared on a background of 9 years of experience from the prophylactic occlusion balloon technique implementation, in a tertiary referal centre for high risk pregnancy patients with invasive placentation. Over 40 procedured have been performed.  

References: Thurn L, Lindqvist PG, Jakobsson M. Abnormally invasive placenta-prevalence, risk factors and antenatal suspicion: results from a largepopulation-based pregnancy cohort study in the Nordic countries. BJOG. 2016 Jul;123(8):134[...]

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