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The clinical evaluation of internal iliac arteries balloon occlusion for placenta accreta spectrum.

OBJECTIVES
To evaluate the balloon occlusion of the internal iliac arteries during a caesarean section in the group of patients with placenta accreta spectrum.


MATERIAL AND METHODS
We analysed 29 pregnant women with placenta accreta spectrum. The study group consisted of 15 patients, who underwent a caesarean delivery with temporary bilateral internal iliac artery occlusion. In the control group, we examined 14 women who had a standard caesarean delivery without any radiologic procedure. We compared pre- and post-operative haemoglobin level, necessity of blood transfusion, intraoperative blood loss, intensive care requirement, complications, duration of surgery, anaesthesia and hospital stay.


RESULTS
The history and obstetric outcomes were similar in both groups. The study group required fewer blood transfusions than the control group (p = 0.0176). We administered less packed red blood cells and fresh frozen plasma. Complications were more frequent in the control group (p = 0.0014). Complications related to occlusion of the internal iliac arteries did not occur. The intensive care unit transfer was more frequent in the control group (p = 0.0329). The duration of surgery and hospital stay did not differ between groups. The anaesthesia time was longer in a study group, which related to the radiologic procedure.


CONCLUSIONS
Caesarean delivery for placenta accreta spectrum with bilateral balloon occlusion of the internal iliac arteries requires fewer transfusions. It contributes to a decrease in the complication rate and maternal morbidity.