Perioperative Endovascular Internal Iliac Artery Occlusion Balloon Placement in Management of Placenta Accreta
- 1 November 2007
- journal article
- research article
- Published by American Roentgen Ray Society in American Journal of Roentgenology
- Vol. 189 (5), 1158-1163
- https://doi.org/10.2214/ajr.07.2417
Abstract
The purpose of our study was to evaluate the efficacy of the perioperative placement of occlusion balloons within the internal iliac arteries in reducing intraoperative blood loss and transfusion requirements during cesarean delivery for women with placenta accreta or its variants. Over a 30-month period, 11 patients with placenta accreta or its variants underwent cesarean delivery after bilateral internal iliac artery occlusion balloon placement (study group). The intraoperative blood loss and transfusion volumes, immediate postoperative change in hemoglobin levels, duration of surgery, and length of ICU stay and hospitalization of this study group were compared with 14 similar patients who underwent cesarean delivery without occlusion balloon placement over a 36-month period (control group). The mean intraoperative blood loss in the study group (2,011 mL; range, 400-5,000 mL) was 39.4% less than in the control group (3,316 mL; range, 1,000-4,000 mL) (p = 0.042). The mean volume of blood transfused was 52.1% less in the study group (1,058 mL; range, 0-3,600 mL) than in the control group (2,211 mL; range, 1,190-3,980 mL) (p = 0.005). There was no significant difference in the immediate postoperative change in hemoglobin levels (p = 0.44), length of hospitalization (p = 0.203), or ICU admission (p = 0.614). The duration of the surgery was significantly less in the study group (p = 0.046). Perioperative internal iliac artery occlusion balloon placement is a safe and minimally invasive technique that reduces intraoperative blood loss and transfusion requirements in patients with placenta accreta and its variants undergoing cesarean delivery.Keywords
This publication has 26 references indexed in Scilit:
- Temporary balloon occlusion of the common iliac artery: New approach to bleeding control during cesarean hysterectomy for placenta percretaAmerican Journal of Obstetrics and Gynecology, 2005
- Arterial embolization and prophylactic catheterization for the treatment for severe obstetric hemorrhage*Acta Obstetricia et Gynecologica Scandinavica, 2005
- Conservative Management of Placenta Previa Percreta in a Jehovah's WitnessObstetrics & Gynecology, 2005
- Surgical uterine devascularization for placenta accreta: immediate and long‐term follow‐upActa Obstetricia et Gynecologica Scandinavica, 2005
- Tourniquet technique prevents profuse blood loss in placenta accreta cesarean sectionJournal of Obstetrics and Gynaecology Research, 2005
- Antenatal diagnosis of placenta percreta with planned in situ retention and methotrexate therapy in a woman infected with HIVUltrasound in Obstetrics & Gynecology, 2002
- Failure of methotrexate and internal iliac balloon catheterization to manage placenta percretaObstetrics & Gynecology, 2002
- Prophylactic Perioperative Hypogastric Artery Balloon Occlusion in Abnormal PlacentationAmerican Journal of Roentgenology, 2001
- Diagnosis and Management of Placenta PercretaObstetrical & Gynecological Survey, 1998
- Placenta percreta: Balloon occlusion and embolization of the internal iliac arteries to reduce intraoperative blood lossesAmerican Journal of Obstetrics and Gynecology, 1997