Case-control comparison of cesarean hysterectomy with and without prophylactic placement of intravascular balloon catheters for placenta accreta.
OBJECTIVE
The objective of the study was to compare outcomes of women with placenta accreta who underwent cesarean hysterectomy with and without prophylactic intravascular balloon catheters.


METHODS
Case-control study of women at risk for placenta accreta identified using hospital databases and billing records from January 1995 to January 2006. Subjects with preoperative intravascular balloon catheter (BC) placement plus hysterectomy were compared with those that had hysterectomy alone.


RESULTS
Sixty-nine subjects had cesarean hysterectomy performed for placenta accreta; 19 subjects had balloon catheters plus hysterectomy and 50 subjects had hysterectomy alone. No significant differences were noted in estimated blood loss (P = .79), transfused blood products (P = .60), operative time (P = .85), and postoperative hospital days (P = .85). There were no significant differences in secondary outcomes between groups. Three of the 19 BC subjects (15.8%) had complications from catheter placement; 2 required stent placement and/or arterial bypass.


CONCLUSIONS
Prophylactic intravascular balloon catheters did not benefit women with placenta accreta undergoing cesarean hysterectomy.
Shrivastava
Vineet
V
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Irvine Medical Center, University of California, Orange, CA, USA.
Nageotte
Michael
M
Major
Carol
C
Haydon
Michael
M
Wing
Deborah
D
D000328:Adult; D001724:Birth Weight; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D016022:Case-Control Studies; D002404:Catheterization / Q000379:methods*; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007231:Infant, Newborn; D010921:Placenta Accreta / Q000601:surgery*; D006473:Postpartum Hemorrhage / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies