A case of pregnancy and childbirth after uterine artery embolization with a permanent embolic agent

Objective: To report a case of full-term delivery after uterine artery embolization with N-butyl cyanoacrylate for abruptio placentae. Design: Case report. Setting: University hospital. Patient(s): A 35-year old woman, gravida 2 para 0, at 32 weeks’ and 4 days’ gestation. Intervention(s): Transcatheter arterial embolization with N-butyl cyanoacrylate (NBCA). Result(s): An emergency cesarean section was performed for abruptio placentae. The neonate died on day 0. After the cesarean section, a hematoma was found at the uterine incision that continued to increase. Therefore, pelvic angiography was performed, and extravasation was observed from the uterine arteries. NBCA was used for embolization, and the extravasation stopped rapidly. Total transfusion volume was 10,190 mL. Nine months after the cesarean section, the patient became pregnant naturally and delivered a boy by elective cesarean section. Conclusion(s): For treatment of shock caused by perinatal hemorrhage, which is a major cause of perinatal mortality, even if clotting abnormalities are present, transcatheter arterial embolization using NBCA can provide effective hemostasis. Moreover, in patients who would otherwise require a hysterectomy, fertility can be preserved. (Fertil Steril� 2011;95:290.e9–e11. � 2011 by American Society for Reproductive Medicine.)