Balloon Occlusion of the Abdominal Aorta during Caesarean Hysterectomy for Placenta Percreta

Paull, John; Smith, Jason W.; Williams, Leslie; Davison, George; Devine, T; Holt, Maxine

doi:10.1177/0310057x9502300616

Cited by 102 publications

(67 citation statements)

References 14 publications

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“…Patient characteristics, anaesthetic and surgical details and fetal data are shown in Table 1. General anaesthesia was used in 38 patients with mean induction-to-delivery interval 4.2 min [range [3][4][5][6][7][8][9][10][11][12] and mean time from induction to first balloon inflation 5.8 min [range [4][5][6][7][8][9][10][11][12][13]. Epidural anaesthesia was used in seven patients of whom three required conversion to general anaesthesia (two patients for inability to cope and one patient for insufficient analgesia).…”

Section: Resultsmentioning

confidence: 99%

“…7,8 However, reports of abdominal aorta balloon occlusion have been published. [9][10][11][12] In this case series, we present our experience with prophylactic lower abdominal aorta balloon occlusion (PABO) in the management of 45 women with morbidly adherent placenta undergoing caesarean section. The efficacy, risks and benefits of this technique as well as the anaesthetic management are discussed.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prophylactic abdominal aorta balloon occlusion during caesarean section: a retrospective case series

Wei

Zhang

Chu

et al. 2016

International Journal of Obstetric Anesthesia

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prophylactic abdominal aorta balloon occlusion during caesarean section: a retrospective case series

Wei

Zhang

Chu

et al. 2016

International Journal of Obstetric Anesthesia

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“…2,[4][5][6][7][8][9][10][11][12][13][14] The search was performed through PubMed, using the following keywords: placenta percreta, balloon occlusion, and internal iliac artery occlusion. Our search resulted in 50 articles and was selectively reduced, based on a collective decision by all authors, according to the following criteria: (1) All patients were diagnosed with abnormal placentation; (2) all patients had a prophylactic placement of endovascular balloons prior to cesarean delivery; and (3) patients who underwent embolization were included within the literature review.…”

Section: Critical Analysis Of Previous Literature and Search Methodologymentioning

confidence: 99%

Selective Endovascular Balloon–Occlusion for Cesarean Delivery in Patients with Abnormal Placentation: Review of Literature and Presentation of a Case

Mangar

Kolla

Karlnoski

et al. 2009

Journal of Gynecologic Surgery

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Background: Removal of abnormal placentation is associated with severe bleeding and is a recognized cause of maternal morbidity and mortality. Complications of abnormal placentation include excessive bleeding during placental removal and the need for cesarean hysterectomy. Newer technologic advances, in the form of obstetrical ultrasound and advanced computed tomography and magnetic resonance imaging, have enabled antenatal diagnosis of these abnormalities and, therefore, allow elective management, instead of on an emergency basis. Case: In this article, we report a case that demonstrates the use of electively placed, bilateral intravascular balloons guided within the common iliac arteries to control bleeding in a patient with placenta percreta. Review: We also complete a review on the literature pertaining to the role of vascular balloon occlusion in abnormal placentation. The use of occlusive balloons and=or embolization has recently been described to reduce postoperative blood loss in patients with abnormal placentation; however, several described anastomoses can explain the continued bleeding. A review of all publications was completed, regarding abnormal placentation, where an endovascular occlusive balloon and=or embolization were used to reduce blood loss. Conclusions: We conclude that a multidisciplinary approach between the interventional radiologist and the obstetrician are important for a favorable outcome. Prophylactic bilateral common iliac artery balloons placed immediately before surgery in patients with abnormal placentation is the safest method by which a reduction in blood loss may be obtained. However, further research and prospective studies are needed to properly assess the efficacy of each of the described techniques for better control of bleeding in these patients, as well as the most appropriate timing for repeated occlusive periods, to minimize unfavorable ischemic events. ( J GYNECOL SURG 25:113)

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“…Placement of occlusion balloons has been performed at various sites from as proximal as the aorta (Paull et al 1995;Panici et al 2012) to more distally within the anterior division of the internal iliac arteries (Dubois et al 1997). More oft en than not, this technique has been combined with concomitant arterial embolisation.…”

Section: Artery Occlusion Balloonmentioning

confidence: 99%

Systematic review of uterus-preserving treatment modalities for abnormally invasive placenta

Mei

Zou

et al. 2015

Journal of Obstetrics and Gynaecology

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This is a systematic review for evaluating failure rates (secondary hysterectomy or maternal mortality) and success rates (subsequent menstruation or pregnancy) following radiological or conservative surgical interventions for abnormally invasive placenta (AIP). Twelve cohort studies and 8 case series or case reports were included. The cumulative outcomes showed success rates of 159/177 (89.8) for arterial embolisation, a secondary hysterectomy in 20/177 (11.3%), a subsequent menstruation in 74/85 (87.1%) and a subsequent pregnancy in 3/10 (30%). Artery occlusion balloon presented a success rate of 33/42 (78.6%), and a secondary hysterectomy presented that of 8/42 (19%). Uterus-preserving surgery showed a success rate of 48/76 (63.2), a secondary hysterectomy in 23/76 (30%), maternal mortality in 2/54 (3.7%), a subsequent menstruation in 20/37 (81.1%) and a subsequent pregnancy in 21/27 (77.8%). This review indicates that different uterine-sparing radiological and surgical techniques may be effective in managing AIP in select patients.

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Balloon Occlusion of the Abdominal Aorta during Caesarean Hysterectomy for Placenta Percreta

Cited by 102 publications

References 14 publications

Prophylactic abdominal aorta balloon occlusion during caesarean section: a retrospective case series

Prophylactic abdominal aorta balloon occlusion during caesarean section: a retrospective case series

Selective Endovascular Balloon–Occlusion for Cesarean Delivery in Patients with Abnormal Placentation: Review of Literature and Presentation of a Case

Systematic review of uterus-preserving treatment modalities for abnormally invasive placenta

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