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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

  • Clinical Investigation
  • Arterial Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Objective

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgements

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.

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Authors and Affiliations

  1. Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, No. 1, East Jian She Road, Zhengzhou, 450052, Henan Province, People’s Republic of China

    Juanfang Liu, Yanli Wang, Dechao Jiao, Wenjun Zhang & Xinwei Han

Authors
  1. Juanfang Liu
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  2. Yanli Wang
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  3. Dechao Jiao
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  4. Wenjun Zhang
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  5. Xinwei Han
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Contributions

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.

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Correspondence to Xinwei Han.

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Liu, J., Wang, Y., Jiao, D. et al. 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. Cardiovasc Intervent Radiol 42, 829–834 (2019). https://doi.org/10.1007/s00270-019-02170-4

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  • DOI: https://doi.org/10.1007/s00270-019-02170-4

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