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

摘要

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.