The clinical evaluation of internal iliac arteries balloon occlusion for placenta accreta spectrum
Abstract
Objectives: To evaluate the balloon occlusion of the internal iliac arteries during a caesarean section in the group of
patients with placenta accreta spectrum.
Material and methods: We analysed 29 pregnant women with placenta accreta spectrum. The study group consisted of
15 patients, who underwent a caesarean delivery with temporary bilateral internal iliac artery occlusion. In the control group,
we examined 14 women who had a standard caesarean delivery without any radiologic procedure. We compared pre- and
post-operative haemoglobin level, necessity of blood transfusion, intraoperative blood loss, intensive care requirement,
complications, duration of surgery, anaesthesia and hospital stay.
Results: The history and obstetric outcomes were similar in both groups. The study group required fewer blood transfusions
than the control group (p = 0.0176). We administered less packed red blood cells and fresh frozen plasma. Complications
were more frequent in the control group (p = 0.0014). Complications related to occlusion of the internal iliac arteries did
not occur. The intensive care unit transfer was more frequent in the control group (p = 0.0329). The duration of surgery
and hospital stay did not differ between groups. The anaesthesia time was longer in a study group, which related to the
radiologic procedure.
Conclusions: Caesarean delivery for placenta accreta spectrum with bilateral balloon occlusion of the internal iliac arteries
requires fewer transfusions. It contributes to a decrease in the complication rate and maternal morbidity.
Keywords: internal iliac artery occlusionplacenta accreta spectrum
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