Intraoperative aortic balloon occlusion in patients with placenta previa and/or placenta accreta: a retrospective study

Abstract

OBJECTIVE: To introduce the primary experience of using aortic balloon catheters during cesarean section for placenta previa and/or placenta accreta. MATERIALS AND METHODS: From January 2013 to May 2015, 43 patients who were preoperatively diagnosed with major placenta previa and/or placenta accreta and who underwent prophylactic aortic catheterization before caesarean section (CS) were included in the study. We analyzed the clinical data of the study population. Surgery- and catheterization-related complications were also reported. RESULTS: Major placenta previa or placenta accreta was surgically confirmed in 42 patients, 28 of whom had both conditions. The mean patient age was 32.3 ± 5.5 years, whereas the median gestational age at delivery was 260 (range, 153-280) days. Twenty-nine (67.4%) patients had previously undergone CS, and 13 (30%) patients had undergone emergency surgery for antenatal hemorrhage. The median estimated blood loss during surgery was 500 (range, 100-3,000) mL, and the median duration of occlusion was 20 (range, 5-32) minutes. Hysterectomy was performed in five (11.6%) patients and uterine artery embolization in two (4.6%) patients. Two patients with placenta percreta experienced surgery-related complications, and two patients required hospital readmission. No major catheterization-related complications were observed. Forty-two live births were recorded, and the Apgar score of the infants at 5 minutes was > 7. CONCLUSION: Intraoperative aortic balloon occlusion is a relatively safe method for treating placenta previa and/or placenta accreta during scheduled and emergency CS and might be helpful to prevent hysterectomy and embolization in women wishing to preserve fertility.