Management of placenta previa/accreta: consider pre-op aortic catheterization

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  • Placement of aortic balloon catheter prior to high-risk cesarean delivery (CD) may help preserve future fertility.

Why this matters

  • Placenta previa/accreta associated with significant morbidity and mortality due to hemorrhage.
  • Multidisciplinary coordination may help minimize complications.

Key results

  • Median occlusion duration was 20 min.
  • 34.8% of catheters were inflated prior to uterine incision and 65.2% after delivery.
  • 74.4% had an obvious decrease in bleeding after inflation of the balloon.
  • 5 women underwent immediate hysterectomy due to uncontrolled bleeding.
  • 2 women went to the interventional radiology (IR) suite for embolization after the CD.
  • No major catheterization complications were observed.
  • Timing of balloon inflation did not affect estimated blood loss (700 mL vs 500 mL; P=.56).