Perioperative Temporary Occlusion of the Internal Iliac Arteries as Prophylaxis in Cesarean Section at Risk of Hemorrhage in Placenta Accreta

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP CARNEVALE, Francisco Cesar FMUSP-HC
KONDO, Mario Macoto FMUSP-HC
SOUSA JR., Wilson de Oliveira
SANTOS, Aline Barbosa FMUSP-HC
LEAL FILHO, Joaquim Mauricio da Motta FMUSP-HC
FRANCISCO, Rossana Pulcinelli Vieira FMUSP-HC
ZUGAIB, Marcelo FMUSP-HC 2011
dc.identifier.citation CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, v.34, n.4, p.758-764, 2011
dc.identifier.issn 0174-1551
dc.description.abstract 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.
dc.language.iso eng
dc.publisher SPRINGER
dc.relation.ispartof Cardiovascular and Interventional Radiology
dc.rights restrictedAccess
dc.subject Postpartum hemorrhage; Iliac artery; Endovascular procedures; Fluoroscopy; Placenta accreta/therapy; Cesarean section; Uterine hemorrhage
dc.subject.other obstetric hemorrhage; balloon occlusion; abnormal placentation; embolization; previa; ligation; increta; patient
dc.title Perioperative Temporary Occlusion of the Internal Iliac Arteries as Prophylaxis in Cesarean Section at Risk of Hemorrhage in Placenta Accreta
dc.type article
dc.rights.holder Copyright SPRINGER LIM/44 LIM/57
dc.identifier.doi 10.1007/s00270-011-0166-2
dc.identifier.pmid 21598085
dc.type.category original article
dc.type.version publishedVersion CARNEVALE, Francisco Cesar:HC:INRAD KONDO, Mario Macoto:HC:ICHC SANTOS, Aline Barbosa:HC:INRAD LEAL FILHO, Joaquim Mauricio da Motta:HC:INCOR MOREIRA, Airton Mota:HC:ICESP BARONI, Ronaldo Hueb:HC:INRAD FRANCISCO, Rossana Pulcinelli Vieira:FM:MOG ZUGAIB, Marcelo:FM:MOG · SOUSA JR., Wilson de Oliveira:Univ Sao Paulo, Hosp Clin, Intervent Radiol Unit, Sch Med, BR-05403001 Sao Paulo, Brazil WOS:000294815400010 2-s2.0-79960902532 NEW YORK USA
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dc.description.index MEDLINE
hcfmusp.citation.scopus 89 Brasil
hcfmusp.scopus.lastupdate 2021-08-27

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