Arterial embolus during common iliac balloon catheterization at cesarean hysterectomy.

BACKGROUND: Placenta accreta is associated with significant maternal morbidity. Prophylactic iliac artery balloon placement has been described as a treatment adjunct to minimize maternal risk of excessive blood loss at hysterectomy. CASE: A 37-year-old multigravida presented at 37 weeks of gestation with a known placenta previa and suspected placenta accreta. Iliac artery balloon catheters were placed immediately before cesarean delivery. The balloons were inflated after the infant was delivered, and placental-site hemorrhage required a cesarean hysterectomy with a 1,500-mL blood loss. A left popliteal arterial thrombus diagnosed postoperatively required thromboembolectomy. The patient was discharged home on postoperative day 5 with no further sequelae.
CONCLUSION: Prophylactic arterial balloon occlusion may be associated with risks unique to pregnant women.