Ultrasound-guided prophylactic abdominal aortic balloon occlusion for placenta accreta spectrum disorder: A case series.
Mandeep GrewalMichael MagroKrishna Prasad Bellam PremnathSorina BologaChineze OtigbahPublished in: Journal of clinical imaging science (2023)
Placenta accreta spectrum (PAS) disorder is one of the most dangerous conditions that can affect pregnancy and its incidence is increasing secondary to rising cesarean section rates worldwide. The standard treatment is frequently elective hysterectomy at the time of cesarean delivery; however, uterine and fertility preserving surgery is becoming more common. In the pursuit of a reduction in blood loss and associated maternal morbidity, occlusive vascular balloons are increasingly used at the time of surgery, usually placed with fluoroscopic guidance. Occlusive balloons placed in the infrarenal aorta have been shown in the literature to be superior in terms of blood loss and hysterectomy rates than those placed more distally, such as within iliac or uterine arteries. We present the first five cases performed in Europe of ultrasound-guided infrarenal aortic balloon placement before cesarean for PAS disorder, and describe the technique we used, which provided reduced blood loss, a clearer operating field and avoided fetal and maternal exposure to radiation and intravenous contrast.
Keyphrases
- ultrasound guided
- minimally invasive
- abdominal aortic
- coronary artery bypass
- pregnancy outcomes
- spectrum disorder
- fine needle aspiration
- aortic valve
- birth weight
- pulmonary artery
- systematic review
- sickle cell disease
- abdominal aortic aneurysm
- magnetic resonance
- surgical site infection
- patients undergoing
- aortic aneurysm
- high dose
- preterm birth
- risk factors
- pregnant women
- left ventricular
- aortic dissection
- coronary artery
- radiation therapy
- magnetic resonance imaging
- computed tomography
- percutaneous coronary intervention
- blood flow
- low dose
- gestational age
- physical activity
- atrial fibrillation
- acute coronary syndrome