Perioperative Utilization of Internal Iliac Artery Balloons, Does it really help in Case of Abnormal Placental Invasion?

Abstract

The abnormal placental invasion is characterized by partial or complete abnormal adherence of the placenta to the underlying uterine wall (accreta, increta and percreta) [1,2]. It is correlated with significant morbidity and mortality for both mother and fetus, mainly because of the severe peripartum bleeding and preterm birth [3,4]. Maternal mortality is almost 7%, despite optimal planning and surgical management [4,5]. Recent years, some people claim that perioperative use of internal iliac artery balloons may be helpful in patients with abnormal placental invasion [5,6]. However, the utilization of this technique represents an area of ongoing debate, mainly because its efficacy still remains unproven [5,6].

Introductory Chapter: Is It Time to Reconsider the Importance of Cesarean Section?

“…Based on recent studies, cesarean section is associated with increased risk of severe maternal complications such as: perioperative hemorrhage (requiring blood transfusion or obstetric hysterectomy), uterine rupture, bladder injury, thromboembolic events, intra-abdominal hematomas, wound infection, anesthetic complications, and prolonged hospitalization [4]. Especially in repeated cesarean sections, there is increased risk for abnormal placental invasion as well as for severe perioperative complications [5][6][7].…”