Journal article
Perioperative Temporary Occlusion of the Internal Iliac Arteries as Prophylaxis in Cesarean Section at Risk of Hemorrhage in Placenta Accreta
Cardiovascular and interventional radiology, Vol.34(4), pp.758-764
08/01/2011
DOI: 10.1007/s00270-011-0166-2
PMID: 21598085
Abstract
Purpose The purpose of this study was to describe the preliminary results of prophylactic temporary balloon occlusion of the internal iliac arteries for bleeding control in patients with placenta accreta during cesarean hysterectomy.
Methods From May 2006 to March 2010, 21 patients diagnosed with placenta accreta using ultrasound and/or magnetic resonance imaging were submitted to prophylactic balloon occlusion before hysterectomy. Fluoroscopy, balloon occlusion time, surgical duration, intraoperative blood loss, transfusion volume, and procedure complications were analyzed.
Results The mean age was 30.5 years with a mean of 3.6 previous gestations. Imaging studies revealed that all patients had placenta accreta and all were submitted to cesarean hysterectomy. One hysterectomy was due to previous diagnosis of fetal death and another due to cesarean with uterine curettage. Mean fluoroscopy time was 7.5 min, balloon occlusion time was 164 min, and surgery duration was 260 min. Estimated blood loss was 1,671.5 ml with mean reposition fluids of 3,538 ml of crystalloids, 309.5 ml of colloids, and 1.24 ml of packed red blood cells. Two patients were submitted to thromboembolectomy due to prolonged surgical time. There was no maternal or fetal mortality related to the procedure.
Conclusions The results demonstrated that prophylactic balloon occlusion of internal iliac artery is a safe method and appears to reduce blood loss and transfusion requirements in patients diagnosed with placenta accreta who undergo cesarean hysterectomy. Antenatal imaging diagnosis of placenta accreta enables preoperative planning.
Details
- Title: Subtitle
- Perioperative Temporary Occlusion of the Internal Iliac Arteries as Prophylaxis in Cesarean Section at Risk of Hemorrhage in Placenta Accreta
- Creators
- Francisco Cesar Carnevale - Universidade de São PauloMario Macoto Kondo - Universidade de São PauloWilson de Oliveira Sousa - Universidade de São PauloAline Barbosa Santos - Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloJoaquim Mauricio da Motta Leal Filho - Universidade de São PauloAirton Mota Moreira - Universidade de São PauloRonaldo Hueb Baroni - Universidade de São PauloRossana Pulcinelli Vieira Francisco - Universidade de São PauloMarcelo Zugaib - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
- Resource Type
- Journal article
- Publication Details
- Cardiovascular and interventional radiology, Vol.34(4), pp.758-764
- DOI
- 10.1007/s00270-011-0166-2
- PMID
- 21598085
- NLM abbreviation
- Cardiovasc Intervent Radiol
- ISSN
- 0174-1551
- eISSN
- 1432-086X
- Publisher
- Springer Nature
- Number of pages
- 7
- Language
- English
- Date published
- 08/01/2011
- Academic Unit
- Radiology
- Record Identifier
- 9985180934902771
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