Citation: Prophylactic balloon occlusion of the common iliac arteries for the
management of suspected placenta accreta/percreta: conclusions from a short case
series.
Arch Gynecol Obstet. 2015 Feb;291(2):461-5
Authors: Minas V, Gul N, Shaw E, Mwenenchanya S
Abstract: PURPOSE: The management of women with abnormally invasive
placenta remains one of the most challenging aspects of obstetric care. Various
surgical and interventional radiological techniques have been developed to limit
the risk of massive haemorrhage at caesarean section. Here we describe our
experience with three such cases that required caesarean hysterectomy and were
managed with prophylactic balloon catheterisation of the common iliac
arteries. METHODS: The details of three cases that received prophylactic
balloon catheterisation of the common iliac arteries for the surgical management
of placenta accreta/percreta are presented. Observational conclusions from these
cases as well as a review of the relevant literature are discussed. RESULTS:
Our three cases required caesarean hysterectomy for suspected placenta
accreta/percreta. The mean estimated blood loss was 3,333 ml. In one of the
cases, we observed notable reduction in blood loss during occlusion of the
common iliac arteries, as the balloons were deflated every 5 min to avoid lower
limb ischemia. CONCLUSIONS: The cases presented here, and also our literature
review, suggest that occlusion of the common iliac arteries appears to be more
effective than, and as safe as the occlusion of the internal iliac arteries.
Clinicians need to be aware of the potential risks and employ measures to
prevent them. Further research is required to investigate the optimum length of
occlusion and balance between reducing blood loss and risking ischemia of the
limbs when occluding the common iliac arteries. PMID: 25178185 [PubMed - indexed for MEDLINE]
Link to PubMed record
