Immediate and long-term results of temporary balloon occlusion of the common iliac arteries in placental ingrowth

Abstract

Objective. To study immediate and long-term results of endovascular reduction of blood flow in placental ingrowth. Patients and methods. The study included 70 pregnant women with ingrowth of the placenta into the uterine scar. The gestational age at time of delivery ranged from 30 to 40 weeks, averaging 35.8 ± 2.9 weeks. In all cases, the reduction of blood flow was performed using balloon catheters placed in the common iliac arteries. Admiral (Invatec) peripheral balloon catheters were used in 55 patients; in 15 patients – balloon catheters used in pediatric practice for dilatation of restrictive interatrial communication (Rashkind balloon). Results. There were no fatal outcomes. Endovascular complications were observed in 4 (5.7%) parturient women. In the longterm period the results were studied in 31 patients. In 22 (71%) patients menstrual function normalized within the first 3 months after the end of lactation. Recovery of menstrual function occurred in 3 (9.7%) women between 3 and 6 months, 2 (6.5%) cases each were in the subgroups with menstrual function recovery between 6 and 9 months and more than 9 months. Menstrual function was not recovered in 2 (6.5%) patients. Conclusion. Temporary balloon occlusion of the common iliac arteries significantly reduces the volume of blood loss, provides better visualization of the surgical area, and creates favorable conditions for subsequent pregnancy. Key words: balloon catheter, placental ingrowth, temporary occlusion of common iliac arteries, bleeding