https://observatorio.fm.usp.br/handle/OPI/23193
Título: | Perioperative Temporary Occlusion of the Internal Iliac Arteries as Prophylaxis in Cesarean Section at Risk of Hemorrhage in Placenta Accreta |
Autor(es): | CARNEVALE, Francisco Cesar; KONDO, Mario Macoto; SOUSA JR., Wilson de Oliveira; SANTOS, Aline Barbosa; LEAL FILHO, Joaquim Mauricio da Motta; MOREIRA, Airton Mota; BARONI, Ronaldo Hueb; FRANCISCO, Rossana Pulcinelli Vieira; ZUGAIB, Marcelo |
Parte de: | CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, v.34, n.4, p.758-764, 2011 |
Resumo: | Purpose The purpose of this study was to describe the preliminary results of prophylactic temporary balloon occlusion of the internal iliac arteries for bleeding control in patients with placenta accreta during cesarean hysterectomy. Methods From May 2006 to March 2010, 21 patients diagnosed with placenta accreta using ultrasound and/or magnetic resonance imaging were submitted to prophylactic balloon occlusion before hysterectomy. Fluoroscopy, balloon occlusion time, surgical duration, intraoperative blood loss, transfusion volume, and procedure complications were analyzed. Results The mean age was 30.5 years with a mean of 3.6 previous gestations. Imaging studies revealed that all patients had placenta accreta and all were submitted to cesarean hysterectomy. One hysterectomy was due to previous diagnosis of fetal death and another due to cesarean with uterine curettage. Mean fluoroscopy time was 7.5 min, balloon occlusion time was 164 min, and surgery duration was 260 min. Estimated blood loss was 1,671.5 ml with mean reposition fluids of 3,538 ml of crystalloids, 309.5 ml of colloids, and 1.24 ml of packed red blood cells. Two patients were submitted to thromboembolectomy due to prolonged surgical time. There was no maternal or fetal mortality related to the procedure. Conclusions The results demonstrated that prophylactic balloon occlusion of internal iliac artery is a safe method and appears to reduce blood loss and transfusion requirements in patients diagnosed with placenta accreta who undergo cesarean hysterectomy. Antenatal imaging diagnosis of placenta accreta enables preoperative planning. |
Aparece nas coleções: | Artigos e Materiais de Revistas Científicas - FM/MOG Artigos e Materiais de Revistas Científicas - HC/ICESP Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - HC/InCor Artigos e Materiais de Revistas Científicas - HC/InRad Artigos e Materiais de Revistas Científicas - LIM/44 Artigos e Materiais de Revistas Científicas - LIM/57 |
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