Objective: To evaluate the effectiveness of temporary balloon occlusion of the internal iliac artery before uterine incision to preventmassive obstetric hemorrhage during cesarean delivery among patients with anterior placenta previa.Methods: In a retrospective cohort study conducted at Amphia Hospital Breda (Breda, Netherlands), data were analyzed from women with anterior placenta previa who delivered by cesarean between January 1, 2001, and September 30, 2012. Cases with andwithout balloon occlusion of the internal iliac artery were included. The primary outcomeswere the amount of blood loss during cesarean delivery, drop of hemoglobin level, and blood loss ofmore than 1000mL.Results: Of 68 eligiblewomen, 42 (62%) had temporary balloon occlusion and 26 (38%) had no balloon occlusion.Median blood loss was 800 mL (interquartile range [IQR] 488-1113) in the balloon group and 1000 mL (IQR 694-1307) in the no balloon group (P= 0.06). Blood loss of 1000 mL or more was recorded in 16 (38%) women in the balloon group and 18 (69%) in the no balloon group (P= 0.01).Conclusion: Temporary balloon occlusion of the internal iliac artery before uterine incision during cesarean delivery could potentially reduce blood loss among patients with anterior placenta previa. Large, randomized controlled trials are needed to confirm the results.
E.A., B., H., V., L.D., V., M.G., D., & D.N., P. (2014). Temporary balloon occlusion of the internal iliac arteries to prevent massive hemorrhage during cesarean delivery among patients with placenta previa. International Journal of Gynecology and Obstetrics. E.A. Broekman, Department of Obstetrics and Gynecology, Amphia Hospital Breda, Langendijk 75, Breda 4819 EV, Netherlands: Elsevier Ireland Ltd. Retrieved from www.elsevier.com/locate/ijgo