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Safety and Efficacy of Aortic Vs Internal Iliac Balloon Occlusion for Cesarean Delivery in Coexisting Placenta Accreta and Placenta Previa

  • Clinical Investigation
  • Arterial Interventions
  • Published:
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Abstract

Purpose

To investigate safety and efficacy of intra-aortic balloon occlusion (IABO) versus internal iliac artery balloon occlusion (IIABO) for cesarean delivery in coexisting placenta accreta and placenta previa.

Materials and Methods

From 2006 to 2019, 60 pregnant women who had undergone preoperative IABO (n = 28) and IIABO (n = 32) for cesarean delivery in coexisting placenta accreta and placenta previa were retrospectively identified, and their medical records and relevant imaging were reviewed.

Results

Maternal characteristics (age, gravidity, previous cesarean delivery, gestational age, and neonatal weight) were similar in both groups. Estimated blood loss, volume of blood transfusion, length of hospitalization, and rate of hysterectomy were not significantly different between the groups. Operation time (the duration of cesarean delivery and hysterectomy, p < 0.05), total time of balloon occlusion (p < 0.01), and fetal radiation dose (p < 0.001) in the IABO group were less than in the IIABO group. No severe complications related to the balloon occlusion procedure were noted in either group.

Conclusion

IABO and IIABO are safe and effective options for cesarean delivery in patients with combined placenta accreta and placenta previa. The average operation time, balloon occlusion time, and fetal radiation dose in patients with IABO are less than in patients with IIABO. There were no complications related to balloon occlusion of the aorta or internal iliac artery.

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Hiroyuki Tokue, Azusa Tokue & Yoshito Tsushima

  2. Department of Obstetrics and Gynecology, Gunma University Hospital, 3-39-33 Showa-machi, Maebashi, Gunma, Japan

    Takashi Kameda

Authors
  1. Hiroyuki Tokue
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  2. Azusa Tokue
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  3. Yoshito Tsushima
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  4. Takashi Kameda
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Contributions

All authors provided clinical expertise and participated in drafting the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hiroyuki Tokue.

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The authors declare that they have no competing interests.

Ethical Approval

Written informed consent was obtained from all patients and residents participating in the study, as approved by the ethics committee of our hospital.

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Written informed consent for publication was obtained from all patients and residents participating in the study.

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Tokue, H., Tokue, A., Tsushima, Y. et al. Safety and Efficacy of Aortic Vs Internal Iliac Balloon Occlusion for Cesarean Delivery in Coexisting Placenta Accreta and Placenta Previa. Cardiovasc Intervent Radiol 43, 1277–1284 (2020). https://doi.org/10.1007/s00270-020-02548-9

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  • DOI: https://doi.org/10.1007/s00270-020-02548-9

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