Prophylactic balloon occlusion of internal iliac arteries in women with placenta accreta: literature review and analysis.

Abstract:

AIM:To review the literature on the use of prophylactic balloon occlusion alone and in conjunction with arterial embolization of the internal iliac arteries in women with placenta accreta. MATERIALS AND METHODS:The PubMed, MEDLINE, CINAHL, EMBASE, and Cochrane Library databases were searched for keywords related to this technique and its use in the avoidance of caesarean hysterectomy. The relevant published articles were selected and then searched for further references. RESULTS:The literature search found 15 case reports and five studies for a total of 20 articles. The use of balloon catheters to prevent post-partum haemorrhage in women with placenta accreta is controversial with some investigators reporting reduced blood loss and transfusion requirements while others reporting no benefit. This procedure does not appear to reduce operative time or hospital stay. Some groups have described catheter-related complications, such as maternal thromboembolic events and the need for stent placement and/or arterial bypass. Thus far, there is no reported maternal or foetal mortality related to this procedure. CONCLUSION:Current evidence is based upon case reports and small retrospective studies. Larger studies or randomized controlled trials are essential in order to demonstrate the safety and efficacy of bilateral iliac balloon occlusion. The creation of a data registry would also facilitate the reporting of this technique.

journal_name

Clin Radiol

journal_title

Clinical radiology

authors

Dilauro MD,Dason S,Athreya S

doi

10.1016/j.crad.2011.10.031

subject

Has Abstract

pub_date

2012-06-01 00:00:00

pages

515-20

issue

6

eissn

0009-9260

issn

1365-229X

pii

S0009-9260(11)00503-4

journal_volume

67

pub_type

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