Perioperative Endovascular Internal Iliac Artery Occlusion Balloon Placement in Management of Placenta Accreta

The purpose of our study was to evaluate the efficacy of the perioperative placement of occlusion balloons within the internal iliac arteries in reducing intraoperative blood loss and transfusion requirements during cesarean delivery for women with placenta accreta or its variants. Over a 30-month p...

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Published inAmerican journal of roentgenology (1976) Vol. 189; no. 5; pp. 1158 - 1163
Main Authors Tan, Cher Heng, Tay, Kiang Hiong, Sheah, Kenneth, Kwek, Kenneth, Wong, Kenneth, Tan, Hak Koon, Tan, Bien Soo
Format Journal Article
LanguageEnglish
Published Leesburg, VA Am Roentgen Ray Soc 01.11.2007
American Roentgen Ray Society
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Abstract The purpose of our study was to evaluate the efficacy of the perioperative placement of occlusion balloons within the internal iliac arteries in reducing intraoperative blood loss and transfusion requirements during cesarean delivery for women with placenta accreta or its variants. Over a 30-month period, 11 patients with placenta accreta or its variants underwent cesarean delivery after bilateral internal iliac artery occlusion balloon placement (study group). The intraoperative blood loss and transfusion volumes, immediate postoperative change in hemoglobin levels, duration of surgery, and length of ICU stay and hospitalization of this study group were compared with 14 similar patients who underwent cesarean delivery without occlusion balloon placement over a 36-month period (control group). The mean intraoperative blood loss in the study group (2,011 mL; range, 400-5,000 mL) was 39.4% less than in the control group (3,316 mL; range, 1,000-4,000 mL) (p = 0.042). The mean volume of blood transfused was 52.1% less in the study group (1,058 mL; range, 0-3,600 mL) than in the control group (2,211 mL; range, 1,190-3,980 mL) (p = 0.005). There was no significant difference in the immediate postoperative change in hemoglobin levels (p = 0.44), length of hospitalization (p = 0.203), or ICU admission (p = 0.614). The duration of the surgery was significantly less in the study group (p = 0.046). Perioperative internal iliac artery occlusion balloon placement is a safe and minimally invasive technique that reduces intraoperative blood loss and transfusion requirements in patients with placenta accreta and its variants undergoing cesarean delivery.
AbstractList The purpose of our study was to evaluate the efficacy of the perioperative placement of occlusion balloons within the internal iliac arteries in reducing intraoperative blood loss and transfusion requirements during cesarean delivery for women with placenta accreta or its variants. Over a 30-month period, 11 patients with placenta accreta or its variants underwent cesarean delivery after bilateral internal iliac artery occlusion balloon placement (study group). The intraoperative blood loss and transfusion volumes, immediate postoperative change in hemoglobin levels, duration of surgery, and length of ICU stay and hospitalization of this study group were compared with 14 similar patients who underwent cesarean delivery without occlusion balloon placement over a 36-month period (control group). The mean intraoperative blood loss in the study group (2,011 mL; range, 400-5,000 mL) was 39.4% less than in the control group (3,316 mL; range, 1,000-4,000 mL) (p = 0.042). The mean volume of blood transfused was 52.1% less in the study group (1,058 mL; range, 0-3,600 mL) than in the control group (2,211 mL; range, 1,190-3,980 mL) (p = 0.005). There was no significant difference in the immediate postoperative change in hemoglobin levels (p = 0.44), length of hospitalization (p = 0.203), or ICU admission (p = 0.614). The duration of the surgery was significantly less in the study group (p = 0.046). Perioperative internal iliac artery occlusion balloon placement is a safe and minimally invasive technique that reduces intraoperative blood loss and transfusion requirements in patients with placenta accreta and its variants undergoing cesarean delivery.
OBJECTIVEThe purpose of our study was to evaluate the efficacy of the perioperative placement of occlusion balloons within the internal iliac arteries in reducing intraoperative blood loss and transfusion requirements during cesarean delivery for women with placenta accreta or its variants.MATERIALS AND METHODSOver a 30-month period, 11 patients with placenta accreta or its variants underwent cesarean delivery after bilateral internal iliac artery occlusion balloon placement (study group). The intraoperative blood loss and transfusion volumes, immediate postoperative change in hemoglobin levels, duration of surgery, and length of ICU stay and hospitalization of this study group were compared with 14 similar patients who underwent cesarean delivery without occlusion balloon placement over a 36-month period (control group).RESULTSThe mean intraoperative blood loss in the study group (2,011 mL; range, 400-5,000 mL) was 39.4% less than in the control group (3,316 mL; range, 1,000-4,000 mL) (p = 0.042). The mean volume of blood transfused was 52.1% less in the study group (1,058 mL; range, 0-3,600 mL) than in the control group (2,211 mL; range, 1,190-3,980 mL) (p = 0.005). There was no significant difference in the immediate postoperative change in hemoglobin levels (p = 0.44), length of hospitalization (p = 0.203), or ICU admission (p = 0.614). The duration of the surgery was significantly less in the study group (p = 0.046).CONCLUSIONPerioperative internal iliac artery occlusion balloon placement is a safe and minimally invasive technique that reduces intraoperative blood loss and transfusion requirements in patients with placenta accreta and its variants undergoing cesarean delivery.
Author Tay, Kiang Hiong
Kwek, Kenneth
Tan, Hak Koon
Sheah, Kenneth
Tan, Bien Soo
Tan, Cher Heng
Wong, Kenneth
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Keywords Human
Postoperative
Nuclear medicine
Pregnancy disorders
Endovascular route
Placenta diseases
Iliac artery
Placenta accreta
Perioperative
Clinical management
Treatment
Surgery
Radiology
Delivery disorders
Artery occlusion
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Snippet The purpose of our study was to evaluate the efficacy of the perioperative placement of occlusion balloons within the internal iliac arteries in reducing...
OBJECTIVEThe purpose of our study was to evaluate the efficacy of the perioperative placement of occlusion balloons within the internal iliac arteries in...
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SubjectTerms Adult
Balloon Occlusion - methods
Biological and medical sciences
Blood Loss, Surgical - prevention & control
Cesarean Section - adverse effects
Delivery. Postpartum. Lactation
Diseases of mother, fetus and pregnancy
Disorders
Embolization, Therapeutic - methods
Female
Gravidity
Gynecology. Andrology. Obstetrics
Humans
Iliac Artery
Investigative techniques, diagnostic techniques (general aspects)
Medical sciences
Perioperative Care - methods
Placenta Accreta - surgery
Pregnancy
Pregnancy. Fetus. Placenta
Treatment Outcome
Title Perioperative Endovascular Internal Iliac Artery Occlusion Balloon Placement in Management of Placenta Accreta
URI http://www.ajronline.org/cgi/content/abstract/189/5/1158
https://www.ncbi.nlm.nih.gov/pubmed/17954654
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