Arterial embolus during common iliac balloon catheterization at cesarean hysterectomy.
BACKGROUND
Placenta accreta is associated with significant maternal morbidity. Prophylactic iliac artery balloon placement has been described as a treatment adjunct to minimize maternal risk of excessive blood loss at hysterectomy.


METHODS
A 37-year-old multigravida presented at 37 weeks of gestation with a known placenta previa and suspected placenta accreta. Iliac artery balloon catheters were placed immediately before cesarean delivery. The balloons were inflated after the infant was delivered, and placental-site hemorrhage required a cesarean hysterectomy with a 1,500-mL blood loss. A left popliteal arterial thrombus diagnosed postoperatively required thromboembolectomy. The patient was discharged home on postoperative day 5 with no further sequelae.


CONCLUSIONS
Prophylactic arterial balloon occlusion may be associated with risks unique to pregnant women.
Sewell
Mark F
MF
Department of Maternal-Fetal Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109-1989, USA. msewell@metrohealth.org
Rosenblum
David
D
Ehrenberg
Hugh
H
D000328:Adult; D002404:Catheterization / Q000009:adverse effects; D002585:Cesarean Section / Q000009:adverse effects; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D007083:Iliac Artery; D010921:Placenta Accreta / Q000503:physiopathology; D010923:Placenta Previa / Q000503:physiopathology; D011150:Popliteal Artery / Q000601:surgery; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D011859:Radiography; D012307:Risk Factors; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery