Cesarean Hysterectomy for Abnormal Placentation Using Balloon Occlusion of the Common Iliac Artery: Case Series

Abstract

Objective: To investigate the management and safety of cesarean hysterectomy using common
iliac artery balloon occlusion (CIABO) for placenta percreta/increta/accreta.
Patients and Methods: We performed 4 cesarean hysterectomies at 33-36 weeks of gestation.
All 4 patients had undergone cesarean section previously and had placenta previa. The patients
then underwent cesarean hysterectomy using CIABO.
Results: Two patients were ultimately diagnosed with placenta percreta, one with placenta increta and 1 with placenta accreta. The actual invasive depth of the placenta tended to be deeper
than had been diagnosed before surgery. The volume of blood loss in the 3 patients whose
balloons were placed in the common iliac artery from the start ranged from 1361-3851 ml (including amniotic fluid and fewer amounts of bleeding than these), and these patients received
only autologous blood transfusion. All 4 patients were ultimately discharged from the hospital
without any complications.
Conclusion: We were able to control the blood loss well using CIABO during cesarean hysterectomy. We confirm that our method of managing cesarean hysterectomy for abnormal placentation can be conducted safely.