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Vol 93, No 12 (2022)
Research paper
Published online: 2022-03-14
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Maternal and perinatal outcomes in placenta accreta spectrum disorders with prophylactic internal iliac artery balloon catheterization and embolization

Krzysztof Pyra1, Maciej Szmygin1, Weronika Dymara-Konopka2, Grzegorz Pietras2, Piotr Dziduch2, Marek Grzechnik2, Tomasz Jargiello1, Bozena Leszczynska-Gorzelak2
DOI: 10.5603/GP.a2021.0221
·
Pubmed: 35315022
·
Ginekol Pol 2022;93(12):980-986.
Affiliations
  1. Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Poland
  2. Department of Obstetrics and Perinatology, Medical University of Lublin, Poland

open access

Vol 93, No 12 (2022)
ORIGINAL PAPERS Obstetrics
Published online: 2022-03-14

Abstract

Objectives: To summarize our five-year experience with managing patients diagnosed with wide range of PAS disorder and treated with prophylactic internal iliac balloon implantation prior to cesarean section and to assess maternal and fetal outcomes.

Material and methods: Retrospective cohort study.

Results: A total of 30 patients were included in the study. Hysterectomy was performed in 10 cases — partial hysterectomy in six and total hysterectomy in four. Median estimated blood loss was 1.18 L. In two cases technical complications were noted. In one case bilateral internal iliac artery thrombosis requiring urgent surgical intervention occurred. A total of 30 live infants were delivered. Mean birth weight was 2435 g and mean Apgar score at 1’, 5’ and 10’ minutes was 6.8, 8 and 8.7 respectively. After average 30 days of hospitalization all infants and their mothers were discharged in good clinical condition.

Conclusions: Placenta accreta spectrum remains a challenge for obstetricians and gynecologists and despite interdisciplinary approach is associated with numerous complications with life-threatening postpartum hemorrhage being the most serious one. Prophylactic placement of iliac balloons is a minimally invasive and safe endovascular technique which allows rapid and effective control of postpartum bleeding in patients with PAS, with low complication rate for both mother and the child.

Abstract

Objectives: To summarize our five-year experience with managing patients diagnosed with wide range of PAS disorder and treated with prophylactic internal iliac balloon implantation prior to cesarean section and to assess maternal and fetal outcomes.

Material and methods: Retrospective cohort study.

Results: A total of 30 patients were included in the study. Hysterectomy was performed in 10 cases — partial hysterectomy in six and total hysterectomy in four. Median estimated blood loss was 1.18 L. In two cases technical complications were noted. In one case bilateral internal iliac artery thrombosis requiring urgent surgical intervention occurred. A total of 30 live infants were delivered. Mean birth weight was 2435 g and mean Apgar score at 1’, 5’ and 10’ minutes was 6.8, 8 and 8.7 respectively. After average 30 days of hospitalization all infants and their mothers were discharged in good clinical condition.

Conclusions: Placenta accreta spectrum remains a challenge for obstetricians and gynecologists and despite interdisciplinary approach is associated with numerous complications with life-threatening postpartum hemorrhage being the most serious one. Prophylactic placement of iliac balloons is a minimally invasive and safe endovascular technique which allows rapid and effective control of postpartum bleeding in patients with PAS, with low complication rate for both mother and the child.

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Keywords

abnormally invasive placenta; postpartum hemorrhage; high-risk pregnancy; hysterectomy; surgical techniques

About this article
Title

Maternal and perinatal outcomes in placenta accreta spectrum disorders with prophylactic internal iliac artery balloon catheterization and embolization

Journal

Ginekologia Polska

Issue

Vol 93, No 12 (2022)

Article type

Research paper

Pages

980-986

Published online

2022-03-14

Page views

3555

Article views/downloads

589

DOI

10.5603/GP.a2021.0221

Pubmed

35315022

Bibliographic record

Ginekol Pol 2022;93(12):980-986.

Keywords

abnormally invasive placenta
postpartum hemorrhage
high-risk pregnancy
hysterectomy
surgical techniques

Authors

Krzysztof Pyra
Maciej Szmygin
Weronika Dymara-Konopka
Grzegorz Pietras
Piotr Dziduch
Marek Grzechnik
Tomasz Jargiello
Bozena Leszczynska-Gorzelak

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