Objective: Uterine artery embolization (UAE) is becoming a common treatment for symptomatic leiomyoma. Several pregnancies following UAE have been reported. However, reports are still limited and the risk of complications remains unknown.
Case report: A primigravida conceived after UAE for leiomyoma. She delivered spontaneously at 34 weeks plus 2 days after premature rupture of the membranes. The placenta was located on the interstitial leiomyoma. The patient required manual placental extraction owing to retained placenta and subsequently underwent emergency supracervical hysterectomy for severe postpartum hemorrhage. Placenta accreta was confirmed histologically.
Conclusion: Placenta accreta may occur during pregnancy following UAE. When the implantation site is on the leiomyoma with a hyperechoic rim, there is a high risk of abnormal placental adherence.
Copyright 2010 Taiwan Association of Obstetrics and Gynecology. Published by Elsevier B.V. All rights reserved.