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The Feasibility and Safety of Temporary Transcatheter Balloon Occlusion of Bilateral Internal Iliac Arteries during Cesarean Section in a Hybrid Operating Room for Placenta Previa with a High Risk of Massive Hemorrhage

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Author(s)
Jin-Gon BaeYoung Hwan KimJin Young KimMu Sook Lee
Keimyung Author(s)
Bae, Jin GonKim, Young HwanKim, Jin YoungLee, Mu Sook
Department
Dept. of Obstetrics & Gynecology (산부인과학)
Dept. of Radiology (영상의학)
Journal Title
J Clin Med
Issued Date
2022
Volume
11
Issue
8
Keyword
cesarean sectionplacenta abnormalitiestemporary transcatheter balloon occlusion of the bilateral internal iliac arteries
Abstract
This study aimed to evaluate the feasibility and safety of temporary transcatheter balloon occlusion of bilateral internal iliac arteries (TBOIIA) during cesarean section in a hybrid operating room (OR) for placenta previa (PP) with a high risk of massive hemorrhage. This retrospective study analyzed the medical records of 62 patients experiencing PP with a high risk of massive hemorrhage (mean age, 36.2 years; age range 28–45 years) who delivered a baby via planned cesarean section with TBOIIA in a hybrid OR between May 2019 and July 2021. Operation time, estimated blood loss (EBL), amount of intra- and postoperative blood transfusion, perioperative hemoglobin level, hospital stay after operation, balloon time, fluoroscopy time, radiation dose, rate of uterine artery embolization (UAE) and hysterectomy, and complication-related TBOIIA were assessed. The mean operation time was 122 min, and EBL was 1290 mL. Nine out of sixty-two patients (14.5%) received a blood transfusion. The mean hemoglobin levels before surgery, immediately after surgery and within 1 week after surgery were 11.3 g/dL, 10.4 g/dL and 9.2 g/dL, respectively. In terms of radiation dose, the mean dose area product (DAP) and cumulative air kerma were 0.017 Gy/cm2 and 0.023 Gy, respectively. Ten out of sixty-two patients (16.1%) underwent UAE postoperatively in the hybrid OR. One out of sixty-two patients had been diagnosed with placenta percreta with bladder invasion based on preoperative ultrasound, and thus underwent cesarean hysterectomy following TBOIIA and UAE. While intra-arterial balloon catheter placement for managing PP with a high risk of hemorrhage remains controversial, a planned cesarean section with TBOIIA in a hybrid OR is effective in eliminating the potential risk of intra-arterial balloon catheter displacement, thus reducing intraoperative blood loss, ensuring safe placental removal and conserving the uterus.
Keimyung Author(s)(Kor)
배진곤
김영환
김진영
이무숙
Publisher
School of Medicine (의과대학)
Citation
Jin-Gon Bae et al. (2022). The Feasibility and Safety of Temporary Transcatheter Balloon Occlusion of Bilateral Internal Iliac Arteries during Cesarean Section in a Hybrid Operating Room for Placenta Previa with a High Risk of Massive Hemorrhage. J Clin Med, 11(8), 2160. doi: 10.3390/jcm11082160
Type
Article
ISSN
2077-0383
Source
https://www.mdpi.com/2077-0383/11/8/2160
DOI
10.3390/jcm11082160
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44322
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Obstetrics & Gynecology (산부인과학)
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
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