scholarly journals A prospective observational study evaluating the efficacy of prophylactic internal iliac artery balloon catheterization in the management of placenta previa–accreta

Medicine ◽  
2017 ◽  
Vol 96 (45) ◽  
pp. e8276 ◽  
Author(s):  
Yao Fan ◽  
Xun Gong ◽  
Nan Wang ◽  
Ketao Mu ◽  
Ling Feng ◽  
...  
Keyword(s):  
Observational Study ◽  
Iliac Artery ◽  
Prospective Observational Study ◽  
Internal Iliac Artery ◽  
Placenta Previa ◽  
Internal Iliac

scholarly journals Delayed bleeding after prophylactic bilateral internal iliac artery balloon occlusion in elective caesarean hysterectomy for the management of placenta accreta

2017 ◽  
Vol 6 (4) ◽  
pp. 1656
Author(s):  
Abdul Karim Othman ◽  
Noraslawati Razak ◽  
Mohd Hanif Che Mat
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Placenta Previa ◽  
Balloon Occlusion ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Internal Iliac ◽  
Life Threatening ◽  
Caesarean Hysterectomy ◽  
Placenta Accrete

Morbidly adherent placenta (MAP) can be divided into placenta accrete, placenta increta and placenta percreta. It is associated with high parity, multifetal gestation, advanced maternal age, assisted reproductive technologies, placenta previa, and more importantly a history of caesarean section or uterine surgery. Globally, the incidence of placenta accrete has increased and seems to be in parallel with the increasing rate of caesarean section delivery.Despite rapidly evolving diagnostic imaging, and growing of surgical expertise, morbidly adherent placenta (MAP) remains an important cause of maternal morbidity and mortality, especially related with life-threatening postpartum haemorrhage. Although the choice of treatment for placenta accrete is puerperal hysterectomy, this procedure itself involves a greater risk of intra-operative haemorrhage.Elective caesarean hysterectomy using prophylactic bilateral internal iliac artery balloon occlusion offer an interesting approach which can minimize the risk of intra-operative haemorrhage. However, our case report describes the case of a 28-year old Gravida 3 Para 2 morbidly obese parturient diagnosed to have placenta previa type 3 posterior with accrete who experienced a complication of life threatening massive bleeding post-operatively after an elective caesarean hysterectomy using a prophylactic bilateral internal iliac artery balloon occlusion intra-operatively.

scholarly journals Role of emergency bilateral internal iliac ligation in postpartum hemorrhage

2021 ◽  
Vol 10 (8) ◽  
pp. 3086
Author(s):  
Sunder Pal Singh ◽  
Shipra Misra ◽  
Naresh Sharma
Keyword(s):  
Retrospective Study ◽  
Iliac Artery ◽  
Postpartum Hemorrhage ◽  
Internal Iliac Artery ◽  
Placenta Previa ◽  
Uterine Perforation ◽  
Life Saving ◽  
Internal Iliac ◽  
Early Decision

ABSTRACTBackground: The aim of the study was to determine the effectiveness of emergency bilateral internal iliac ligation in intractable postpartum hemorrhage.Methods: A retrospective study was done on 33 women who have undergone emergency bilateral internal iliac ligation in obstetrics haemorrhage.Results: In all of 33 women under this study bilateral internal iliac ligation was performed in emergency. (11) of the cases were of atonic PPH, placenta previa (8), uterine rapture (7), extension of C-section scar (3), vaginal and cervical laceration (3) and uterine perforation (1). hysterectomy was not performed in any of the cases. internal iliac artery was injured in one case during the procedure and was managed successfully but two patients died during and after the BIIL.Conclusions: BIIL is an effective, less time consuming and life-saving procedure in intractable obstetrics hemorrhage if early decision is taken and performed by practiced surgeons.

Radiologic Intervention of Internal Iliac Artery Occlusion During Cesarean Section for Dangerous Placenta Previa

2020 ◽  
Vol 10 (12) ◽  
pp. 2931-2934
Author(s):  
Qingzhen Zhao ◽  
Na Zhao ◽  
Dengdeng Luo ◽  
Sheng Yue
Keyword(s):  
Cesarean Section ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Placenta Previa ◽  
Artery Occlusion ◽  
Control Group ◽  
Observation Group ◽  
Iliac Artery Occlusion ◽  
Significant Difference ◽  
Internal Iliac

Objective: The cesarean section of dangerous placenta previa always faces the problem of massive hemorrhage. The aim of this study was to analyze the clinical effect of internal iliac artery occlusion combined with obstetric autotransfusion in cesarean section of dangerous placenta previa. Method: From November 2017 to November 2019, 20 patients with placenta previa undergoing cesarean section in our hospital were selected. According to the preoperative MRI and ultrasound diagnosis, the amount of bleeding was evaluated and divided into observation group (n = 6) and control group (n = 14). All patients underwent routine cesarean section and prepared the obstetric autotransfusion device. In the observation group, the internal iliac artery balloon was placed under DSA before operation. After the fetus was taken out, the internal iliac artery was blocked. The internal iliac artery occlusion was not needed in the control group. The total length of stay, Apgar score, the incidence of disseminated intravascular coagulation (DIC), hemorrhagic shock, postoperative infection and renal dysfunction were compared between the two groups. Result: Compared with the relative data in control group, the operation time and postoperative hospital stay of the observation group were significantly shorter, the intraoperative blood loss and blood transfusion were significantly lesser, and the hemoglobin difference before and after operation was significantly lesser. There was no significant difference in the incidence of DIC, hemorrhagic shock, postoperative infection and renal dysfunction between two groups; There was no significant difference in neonatal body mass, Apgar score at 1 min and 5 min. Conclusion: The internal iliac artery occlusion can effectively reduce the amount of bleeding in delivery, promote the recovery of negligence, and have no adverse effect on complications and neonatal outcome.

The Clinical Evaluation of IIA Balloon Occlusion for Pernicious Placenta Previa Patients with Placenta Accreta: A Retrospective Study

2021 ◽  
Author(s):  
Ling Hong ◽  
Aner Chen ◽  
Jinliang Chen ◽  
Xiuxiu Li ◽  
Wenming Zhuang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Iliac Artery ◽  
Caesarean Delivery ◽  
Internal Iliac Artery ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Balloon Occlusion ◽  
Control Group ◽  
Estimated Blood Loss ◽  
Internal Iliac

Abstract Objective: This study aimed to evaluate the clinical efficacy of internal iliac artery(IIA) balloon occlusion in patients with pernicious placenta previa coexisting with placenta accreta. Background: Pernicious placenta previa is frequently reported to be complicated with placenta accreta, which contributes to serious consequences such as severe obstetric postpartum hemorrhage or even maternal mortality. Methods: Fifty-eight pernicious placenta previa patients complicated with placenta accreta were retrospectively reviewed. The ballon group consisted of 23 patients, who underwent a caesarean delivery with internal iliac artery occlusion. 35 patients were in the control group, who had a standard caesarean delivery. The primary outcomes were estimated blood loss (EBL), cesarean hysterectomy, and blood transferring volume. The secondary outcomes were operating time, intraoperative hemostatic approaches, surgical complications, balloon catheter–related complications, length of maternal stay, cost of hospitalization, and neonatal outcomes.Results: No difference was observed in estimated blood loss (EBL), blood transferring percentages and volume, additional measures to secure hemostasis , surgical complications, hospital stay postoperatively and newborn outcomes. More than 40% of the balloon group underwent hysterectomy because of uncontrollable postpartum bleeding (10[43.48%] vs. 11[31.43%],P=0.350).Complications related to occlusion of IIA did not occur.The duration of the surgery of the balloon group was significantly longer than that of the control group(123.52 min±74.76 versus 89.17±48.68,P=0.038), and the total hospitalization cost was also significantly higher than that of the control group(45116.67±9358.67 yuan versus 30615.41±11587.44yuan,P=0.000).Conclusion: IIA balloon occlusion in patients with pernicious placenta previa coexisting with placenta accreta did not reduce the hysterectomy rate during cesarean section, nor did it reduce blood loss and blood transfusion, but it prolonged the duration of the surgery and increased the total cost.

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