30-Year-Old Woman Survives Miscarriage Bleeding with Advanced Embolization – Manipal Hospital Mukundapur

Kolkata: Manipal Hospital, Mukundapur, a unit of the Manipal Hospitals Group – one of India’s largest hospital chains – successfully saved the life of a 30-year-old woman by performing a complex endovascular intervention to control life-threatening bleeding during miscarriage, under the supervision of Dr. Partha Pratim Samui, Senior Consultant and In-charge of Interventional Radiology at Manipal Hospital, Mukundapur.

The woman, a Kolkata resident and mother of a 5-year-old child, was 22 weeks into her second pregnancy when she suffered a miscarriage and was rushed to the Emergency Department with severe, uncontrolled bleeding. Although the foetus was eliminated, the doctors found that the placenta (the organ which provides oxygen and nutrients to the foetus during pregnancy) was abnormally and irreversibly stuck to the uterine wall.

This is a rare condition referred to as Placenta Accreta Spectrum (PAS) – a series of pregnancy complications wherein the placenta penetrates deeper into the uterine wall. Here, it was specifically Placenta Increta, wherein the placenta invades into the uterine muscle, and removing it is not possible without excessive bleeding.

The patient experienced uncontrolled bleeding during the first attempt to evacuate the placenta, putting her life at serious risk. She was immediately stabilised by the doctors using a balloon tamponade (a temporary procedure of arresting bleeding by inserting a balloon within the uterus). A diagnosis was confirmed by an urgent MRI.

To permanently stop the bleeding and prevent removal of the uterus (hysterectomy), the healthcare team chose a newer and less invasive method of Bilateral Uterine Artery Embolisation. In this procedure, a catheter (narrow tube) is introduced into the arteries that bring blood to the uterus, and these arteries are occluded to interrupt blood flow to the placenta.

This arrests the bleeding and leaves the uterus intact. No general anaesthesia or invasive surgery was required.

The operation was successfully performed by the multidisciplinary team of Interventional Radiologists, Gynaecologists, and Anaesthesiologists. The patient stabilised rapidly, the balloon was withdrawn, and the bleeding ceased altogether. She is currently recuperating nicely, has been transferred out of the ICU in 2 days, and was discharged within 5days of her surgery.

Describing the success, Dr. Partha Pratim Samui, Senior Consultant and In-charge Interventional Radiology at Manipal Hospital, Mukundapur, averred, "This young mother came to us in a very critical state, bleeding heavily after a miscarriage.

The placenta was deeply stuck inside the uterus, and trying to remove it with surgery could have caused life-threatening blood loss. In such situations, many women end up losing their uterus to save their lives.

Instead, by using a minimally invasive embolisation procedure, we could control the bleeding without major surgery and preserve her uterus. This means that not only was her life saved, but she still has the chance to have children in the future. For us as doctors, nothing is more satisfying than giving a young woman hope for tomorrow."

The procedural technique not only saved the patient’s life but also helped preserve her uterus, allowing the young woman to avoid a hysterectomy. This is the first instance of such a case being successfully handled at Manipal Hospital, Mukundapur, marking a milestone victory in advanced maternity care.