Prophylactic use of an infrarenal abdominal aorta balloon catheter in pregnancies complicated by placenta accreta.

This study evaluated the surgical and neonatal outcomes of 71 patients diagnosed with placenta accreta before caesarean section with or without placement of a prophylactic abdominal aorta balloon catheter. This study took place at our hospital from January 2013 to May 2015. Thirty patients had a prophylactic balloon catheter inserted (balloon group), and 41 patients did not receive the intervention (control group). The mean estimated blood loss and decrease in haemoglobin after surgery was significantly lower in the balloon group than in the control group. No significant difference was found in duration of operation, transfusion, or percentage requirement of caesarean hysterectomy. The incidence of catheterisation-related complications was 3.3%. One patient had pain in her right leg, caused by an ultrasound-confirmed haematoma in the front wall of the right common femoral artery. No significant difference was found in the rate of surgery-related complications and neonatal outcomes between the groups. Prophylactic placement of an infrarenal abdominal aorta balloon catheter in patients with placenta accreta can effectively reduce intraoperative haemorrhage, without causing any obvious adverse maternal or neonatal outcomes. Impact statement Prophylactic placement of endovascular balloon catheters for controlling intraoperative haemorrhage in women with placenta accreta has been a topic of debate for nearly 2 decades. The most common type of occlusion is internal iliac artery balloon occlusion, only a few studies have focused on intraoperative aortic balloon occlusion This retrospective case-control study included relatively large number of cases and the result shown this technique can effectively reduce intraoperative haemorrhage in patients with placenta accreta, without causing any obvious adverse maternal or neonatal outcomes. It provides another safe and effective method for intraoperative haemorrhage control and even uterine preservation.