The Efficacy of Pre-delivery Prophylactic Trans-catheter Arterial Balloon Occlusion of Bilateral Internal Iliac Artery in Patients with Suspected Placental Adhesion

Overview

Journal Obstet Gynecol Sci

Specialty Gynecology & Obstetrics

Date 2017 Feb 21

PMID 28217667

Citations 4

Authors

Yoon Jin Cho

Yong Taek Oh

Suk Young Kim

Ju Young Kim

Sun Young Jung

Seung Joo Chon

Jeong Ho Kim

Sung Su Byun

Affiliations

Soon will be listed here.

Abstract

Objective: Prophylactic trans-catheter arterial balloon occlusion (PTABO) before cesarean section of placenta previa totalis has been introduced to prevent massive hemorrhage. The purpose of this study is to evaluate the clinical usefulness of PTABO in cases of suspected placental adhesion and to examine antepartal risk factors and perinatal outcomes in women with placental adhesion.

Methods: Between January 2012 and December 2015, 77 patients who had undergone ultrasonography for evaluation of placenta previa were enrolled in this study. Seventeen of these patients with suspected placental adhesion by ultrasonography and Pelvic MRI underwent PTABO before cesarean section and another 59 patients underwent cesarean section without PTABO. Antepartal risk factors and peripartum maternal and neonatal outcomes were compared between patients with PTABO and those without PTABO.

Results: More advanced maternal age, longer in gestational weeks at delivery, and more common previous cesarean section history were observed in the PTABO group. Placenta adhesion, abnormal Doppler findings, and frequency of transfusion were more common in the PTABO group. However there was no significant difference in estimated blood loss, hospital days, and neonatal outcome. It had occurred 3 cases of hysterectomy and 1 case of uterine artery embolization after cesarean section in the PTABO group.

Conclusion: Close surveillance of antepartum risk factors for placental adhesion using ultrasonography and pelvic magnetic resonance imaging is important to prevention of massive hemorrhage during cesarean section. PTABO before cesarean section might result in reduced blood loss and requirement for transfusion during the operation.

Citing Articles

Experience of Managing Suspected Placenta Accreta Spectrum with or without Internal Iliac Artery Balloon Occlusion in Two Lithuanian University Hospitals.

Savukyne E, Liubiniene L, Strelcoviene Z, Nadisauskiene R, Vaboliene E, Machtejeviene E Medicina (Kaunas). 2021; 57(4).

PMID: 33918344 PMC: 8065721. DOI: 10.3390/medicina57040345.

The intraoperative use of internal iliac artery balloon catheters in cesarean deliveries for abnormal invasive placentation: A 3-year retrospective cohort review in Doha, Qatar.

Ahmed H, Minisha F, Babarinsa I, Omar A, Bayo A, Omar K Qatar Med J. 2021; 2021(1):8.

PMID: 33828954 PMC: 7961153. DOI: 10.5339/qmj.2021.8.

Management of massive hemorrhage in pregnant women with placenta previa.

Park H, Cho H Anesth Pain Med (Seoul). 2020; 15(4):409-416.

PMID: 33329843 PMC: 7724116. DOI: 10.17085/apm.20076.

Endovascular interventional modalities for haemorrhage control in abnormal placental implantation deliveries: a systematic review and meta-analysis.

Shahin Y, Pang C Eur Radiol. 2018; 28(7):2713-2726.

PMID: 29404775 DOI: 10.1007/s00330-017-5222-0.

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