Case-control comparison of cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters for placenta accreta

• Published in: American journal of obstetrics and gynecology Vol. 197; no. 4; pp. 402.e1 - 402.e5
• Main Authors: Shrivastava, Vineet, Nageotte, Michael, Major, Carol, Haydon, Michael, Wing, Deborah
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.10.2007
• Subjects: Adult; Birth Weight; Blood Loss, Surgical - prevention & control; Blood Transfusion; Case-Control Studies; Catheterization - methods; cesarean hysterectomy; Cesarean Section - methods; Female; Humans; Hysterectomy - methods; Infant, Newborn; intravascular balloon catheter; Obstetrics and Gynecology; placenta accreta; Placenta Accreta - surgery; Postpartum Hemorrhage - surgery; Pregnancy; Retrospective Studies; placenta accreta; intravascular balloon catheter; cesarean hysterectomy
• ISSN: 0002-9378; 1097-6868; 1097-6868
• DOI: 10.1016/j.ajog.2007.08.001

The objective of the study was to compare outcomes of women with placenta accreta who underwent cesarean hysterectomy with and without prophylactic intravascular balloon catheters. Case-control study of women at risk for placenta accreta identified using hospital databases and billing records from January 1995 to January 2006. Subjects with preoperative intravascular balloon catheter (BC) placement plus hysterectomy were compared with those that had hysterectomy alone. Sixty-nine subjects had cesarean hysterectomy performed for placenta accreta; 19 subjects had balloon catheters plus hysterectomy and 50 subjects had hysterectomy alone. No significant differences were noted in estimated blood loss ( P = .79), transfused blood products ( P = .60), operative time ( P = .85), and postoperative hospital days ( P = .85). There were no significant differences in secondary outcomes between groups. Three of the 19 BC subjects (15.8%) had complications from catheter placement; 2 required stent placement and/or arterial bypass. Prophylactic intravascular balloon catheters did not benefit women with placenta accreta undergoing cesarean hysterectomy.