TEMPORARY BALLOON OCCLUSION OF THE COMMON ILIAC ARTERIES IN PATIENTS WITH POST-CESAREAN UTERINE SCAR AND PLACENTA ACCRETA: ADVANTAGES AND POSSIBLE COMPLICATIONS


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Abstract

Objective. To determine the efficiency and possibility of temporary balloon occlusion of the common iliac arteries during organ-sparing surgery in patients with placenta accreta. Material and methods. The retrospective study analyzed the data available in the labor and delivery records of 34 patients with the placenta grown into the uterine scar after cesarean section. During delivery, all the patients underwent temporary balloon occlusion of the common iliac arteries after fetal expulsion. Results. The use of up-to-date technologies, such as temporary balloon occlusion of the common iliac arteries and instrumental autoerythrocyte reinfusion, allowed for organ-sparing surgery in all the examinees. The mean intraoperative blood loss was 1656±1042 ml; 20.6% of thepuerperas were recorded to have a minimal blood loss of400-700 ml. Postoperative complications were observed in 8.8% and were unassociated with angiosurgery. Conclusion. Temporary balloon occlusion of the common iliac arteries is an effective procedure to reduce blood loss during delivery in patients with placenta accreta and post-cesarean section uterine scar, permitting organ-sparing surgery. It can be recommended for use at third-level hospitals.

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About the authors

Mark A. Kurtser

Email: m.kurtser@mcclinics.ru
Corresponding Member of the Russian Academy of Sciences, Professor, Department of Obstetrics and Gynecology, Pediatric Faculty, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia 117997, Russia, Moscow, Ostrovityanova str. 1

Irina Yu. Breslav

Email: irina_breslav@mail.ru
PhD, doctoral student, Department of Obstetrics and Gynecology, Pediatric Faculty, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia. 117997, Russia, Moscow, Ostrovityanova str. 1

Oleg A. Latyshkevich

Email: latishkevich2003@mail.ru
PhD, chief physician, Center for Family Planning and Reproduction, Moscow Healthcare Department. 117209, Russia, Moscow, Sevastopol Prospect, 24a

Ashot M. Grigoryan

Email: Gashot@inbox.ru
PhD, researcher at the Department of endovascular methods of investigation and treatment of heart and blood vessels, A.N. Bakulev Research Center of Cardiovascular Surgery, Ministry of Health of Russia 121552, Russia, Moscow, Rublevskoe sh. 135

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