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MRI image of the abdomen.. Note: Axial T2-weighted MRI image shows an anterior wall dominant placenta previa totalis and suspected placenta accrete of lower posterior wall (arrow).
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An initial ultrasonography and MRI image showed that the placenta, which completely covered the internal os, was located mainly on the anterior uterine wall to the level of the maternal umbilicus and suspected placenta accrete located lower posterior uterine wall (Fig. 1).
Figure of uterus during operation (left) and schematic model (right).. Notes: Line A shows a marking at edge of placenta guided by ultrasonography. Line B, short dashed line, shows a transverse uterine fundus incision line along line A which part approximately 1 cm.
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A, Fig. 2) guided by ultrasonography, an emergency cesarean section was performed via a transverse fundal uterine incision (Line B, Fig. 2) under general anesthesia. A female infant weighing 3,138 g was born with Apgar scores of 7 and 8 at 1 and 5 min, respectively.
Fluoroscopic shows the endovascular balloons.. Note: Fluoroscopy shows the inflation of the balloons occluded in the common iliac arteries bilaterally (A: right and B: left).
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Immediately after baby was delivered, bilateral common iliac arteries were occluded by inflation of the balloons through the catheters already in place (Fig. 3).
MRI image of the one month after operation.. Note: MRI shows almost normal uterine involution except small myoma located posterior wall.
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The MRI image, which was checked one month after operation, was confirmed almost normal uterus (Fig. 4).