The Role of Interventional Radiology in the Management of Abnormal Placentation

Part of the Medical Radiology book series (MEDRAD)


The prevalence of placenta previa and morbidly placenta accreta is increasing as a result of the increased rate of caesarean sections. Major placenta previa and placenta previa accreta mandate delivery by caesarean section and carry the risk of massive haemorrhage and hysterectomy. Women with placenta accreta are at particular risk of major haemorrhage and its complications. The insertion of prophylactic Internal Iliac Occlusion Balloon Catheters (IIOBCs) is to be carefully considered in cases of placenta accreta and placenta previa accreta and is supported in recent published guidelines. Where IIOBCs are ineffective in controlling haemorrhage, additional gelatine foam embolisation should be considered. Prophylactic internal iliac balloon occlusion with or without embolisation has not however been demonstrated in the literature to reduce the complications of massive haemorrhage or to reduce the need for hysterectomy in placenta accreta. Complications as a result of IIOBCs are not uncommon. Many of these are related to long dwell times and displacement of the balloon catheters and may be minimised by scrupulous technique. Advances in technique, operator experience, the use of closure devices and IR suites fit for obstetric delivery may improve the efficacy and safety of the use of prophylactic IIOBCs with and without embolisation.


Balloon Catheter Internal Iliac Artery Balloon Occlusion Placenta Previa Placenta Accreta 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Royal Infirmary of EdinburghEdinburghUK

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