Prophylactic abdominal aorta balloon occlusion during caesarean section: a retrospective case series

FIGO consensus guidelines on placenta accreta spectrum disorders: Conservative management,

“…There are also very limited data on the use of these adjuvant techniques. [34][35][36][37][38][39][40][41][42][43][44] Preventive devascularization can be achieved by surgical or interventional radiology procedures also used in the management of severe postpartum hemorrhage, such as stepwise uterine surgical devascularization, bilateral uterine or hypogastric artery surgical ligation, iliac artery embolization, or balloon occlusion. Embolization before performing hysterectomy may reduce the risk of intraoperative blood loss 36 and prophylactic devascularization may prevent the occurrence of secondary hemorrhage 37 and could also accelerate placental resorption.…”

“…and a case of ischemic nerve injury attributable to iliac artery thrombosis complicating common iliac balloon catheterization at cesarean hysterectomy.A recent single-institution observational cohort series of 45 cases of PAS disorders reported the use of prophylactic lower abdominal aorta balloon occlusion and found a reduced need for blood transfusion 43. One of the cases was complicated by lower extremity arterial thrombosis and another by ischemic injury to the femoral nerve.…”

Retrospective analysis of placenta previa with abnormal placentation with and without prophylactic use of abdominal aorta balloon occlusion

“…A few small studies have reported the use of abdominal aortic balloon occlusion to manage placenta accreta, but few clinical studies have examined its effectiveness. The aim of the present study was therefore to evaluate the effectiveness of prophylactic abdominal aorta balloon occlusion before cesarean delivery among patients with abnormal placentation.…”

Placenta Praevia and Placenta Accreta: Diagnosis and Management

“…Various combinations have been proposed, including intraoperative internal iliac artery and/or postoperative uterine artery embolisation 202,203 and internal iliac artery [204][205][206][207] or abdominal balloon occlusion. [208][209][210][211][212] The latter technique has been increasingly used in China. However, the methodology of these studies is very heterogeneous with no data on the diagnosis of the different grades of villous invasion and variable confounding factors, such as placental position and number of previous caesarean deliveries.…”

“…A single institution observational cohort study of 45 cases of placenta accreta describes the use of prophylactic lower abdominal aorta balloon occlusion and found a reduced need for blood transfusion. 209 One of the cases was complicated by lower extremity arterial thrombosis and another by ischaemic injury to the femoral nerve. A comparative study of abdominal aortic occlusion versus internal iliac artery occlusion found that aortic balloon occlusion resulted in better clinical outcomes with less blood loss, blood transfusion, balloon insertion time, fluoroscopy time and fetal radiation dose.…”