Temporary balloon occlusion of common iliac arteries during organ preservation surgery in patients with placenta ingrowth
AbstractThe aim of the study was to analyze advantages and complications of temporary balloon occlusion of common iliac arteries during organ preservation surgery in patients with placenta ingrowth.
Material and methods. In the retrospective study, data from 68 patients with placenta ingrowth were analyzed. All of them underwent temporary balloon occlusion of common iliac arteries during delivery or postpartum period.
Results. In 67 of 68 patients with placenta ingrowth metroplasty was performed on the background of temporary balloon occlusion of common iliac arteries. In 50 (75.8%) patients who underwent organ-preserving interventions, blood loss did not exceed 2000 ml. In 13 (19.7%) new mothers blood loss was 400-700 ml. In 1 patient with intraoperatively detected placenta ingrowth, metaplasty was performed on the 13th day of the postpartum period. Establishment of the methodology led not only to declining number of patients with extremely massive blood loss, but also to decreasing in median blood loss in rest of the patients, which amounted to 1000-1450 ml. Postoperative complications were observed in 9 (13.2%) patients, only in 2 of them they were caused by angiosurgical intervention.
Conclusion. Temporary balloon occlusion of common iliac arteries allows to perform organ preservation surgery in case of placenta ingrowth. Methodic effectiveness is confirmed by reduction in blood loss during surgery, low hysterectomy index (1.5%), and possibility of delayed postpartum applicability.
Keywords:placenta ingrowth, organ preservation surgery, temporary balloon occlusion of common iliac arteries
Obstetrics and Gynecology: News, Opinions, Training. 2018; 6 (4): 31-7. doi: 10.24411/2303-9698-2018-14003.