Prophylactic Occlusion Balloon Placement in the Abdominal Aorta Combined with Uterine or Ovarian Artery Embolization for the Prevention of Cesarean Hysterectomy Due to Placenta Accreta: A Retrospective Study
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To evaluate the outcomes of uterine-conserving surgery with the occlusion balloon technique followed by uterine or ovarian artery embolization (OAE) in women with placenta accreta.
A total of 31 consecutive patients, who were diagnosed with placenta accreta through grayscale ultrasonography or magnetic resonance imaging prenatally, were retrospectively analyzed in our hospital between October 2015 and September 2017. All of the women underwent a Cesarean section combined with prophylactic placement of a balloon catheter in the abdominal aorta followed by uterine artery embolization (UAE) or OAE when necessary.
Technical success was achieved in 31 cases (100%), including successful catheterization and inflation of balloons. The uterus was conserved in 30 (96.77%) patients. The estimated blood loss, packed RBC transfused, and the operation time were 1906.45 ± 1117.64 ml, 4(0–6) U, and 88.68 ± 28.35 min, respectively. Out of all of the patients, we found nine cases of bleeding after the release of the balloon. Among these patients, six cases originated from the ovarian arteries and three cases originated from uterine arteries. Further embolization was performed through catheterization. The mean fetal radiation exposure was 4.33 ± 0.79 mGy.
Prophylactic abdominal aorta balloon occlusion followed by UAE or OAE can effectively control postpartum hemorrhaging with reduced blood loss, transfusion requirements, and hysterectomy rates in patients with placenta accreta.
KeywordsBalloon catheter Inferior abdominal aorta Placenta accreta Uterine artery embolization Ovarian artery embolization
We would like to acknowledge the whole Interventional Radiology and Obstetric teams of The First Affiliated Hospital of Zhengzhou University for their contribution in the management of these patients.
Juanfang Liu, collected data and wrote manuscript; Dechao Jiao contributed to design; Yanli Wang and Wenjun Zhang contributed to data analysis; Xinwei Han contributed to design and conducted the study.
Compliance with Ethical Standards
Conflict of interest
Authors declare to have no conflict of interest.
- 13.Li K, Zou Y, Sun J, Wen H. Prophylactic balloon occlusion of internal iliac arteries, common iliac arteries and infrarenal abdominal aorta in pregnancies complicated by placenta accreta: a retrospective cohort study. Eur Radiol. 2018.Google Scholar
- 14.Shahin Y, Pang CL. Endovascular interventional modalities for haemorrhage control in abnormal placental implantation deliveries: a systematic review and meta-analysis. Eur Radiol. 2018.Google Scholar