Jessica Papillon-Smith1, Sukhbir Sony Singh2, Cleve Ziegler3. 1. Department of Obstetrics and Gynecology, McGill University Health Centre, Montreal QC. 2. Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa ON. 3. Department of Obstetrics and Gynecology, Jewish General Hospital, Montreal QC.
Abstract
BACKGROUND: Prior to Caesarean section (CS) for morbidly adherent placenta (MAP), endovascular balloons are often placed prophylactically to minimize hemorrhage. However, there have been few reports describing complications of this intervention. CASE: A 41-year-old woman with a diagnosis of placenta percreta had endovascular balloon catheters placed before CS. Intraoperatively the right internal iliac artery ruptured, requiring vascular repair, multiple transfusions of blood and plasma, and admission to the intensive care unit. CONCLUSION: Prophylactic placement of endovascular balloons to reduce maternal hemorrhage at CS for MAP may result in complications. Until more evidence becomes available supporting their use, safety guidelines must be instated in centres using them.
BACKGROUND: Prior to Caesarean section (CS) for morbidly adherent placenta (MAP), endovascular balloons are often placed prophylactically to minimize hemorrhage. However, there have been few reports describing complications of this intervention. CASE: A 41-year-old woman with a diagnosis of placenta percreta had endovascular balloon catheters placed before CS. Intraoperatively the right internal iliac artery ruptured, requiring vascular repair, multiple transfusions of blood and plasma, and admission to the intensive care unit. CONCLUSION: Prophylactic placement of endovascular balloons to reduce maternal hemorrhage at CS for MAP may result in complications. Until more evidence becomes available supporting their use, safety guidelines must be instated in centres using them.
Authors: John C Kingdom; Sebastian R Hobson; Ally Murji; Lisa Allen; Rory C Windrim; Evelyn Lockhart; Sally L Collins; Hooman Soleymani Majd; Moiad Alazzam; Feras Naaisa; Alireza A Shamshirsaz; Michael A Belfort; Karin A Fox Journal: Am J Obstet Gynecol Date: 2020-01-30 Impact factor: 8.661