Role of Interventional Radiology in the Management of Abnormal Placentation

Massive hemorrhage is a complication of the surgical management of abnormal placentation due in no small part to significant collateral blood flow and neovascularization within the uterus and pelvis resulting from an ongoing pregnancy. Integrating various interventional radiology (IR) techniques to reduce the amount of uterine and pelvic blood flow and surgical hemorrhage in patients to both facilitate surgery and decrease risks of morbidity and mortality has been widely employed. There have been unfortunate complications with IR procedures. However, perhaps in specific circumstances, in a setting of highly concerning evidence of severely abnormal placentation such as suspected percreta, the use of occlusive balloon catheters should be considered. Perhaps the greatest challenge in modern obstetrical care is the surgical management of abnormal placentation. One of the largest case control publications involving pathologically proven cases of placenta accreta was that of J. Ballas et al.