title: Multiple complications following the use of prophylactic internal iliac artery balloon catheterisation in a patient with placenta percreta.
abstract: The incidence of placenta praevia/accreta is increasing, placing women at significant risk of postpartum haemorrhage with associated morbidity and mortality. National guidelines recommend prophylactic placement of internal iliac artery balloon occlusion catheters for women with abnormal placentation. We describe an elective caesarean delivery in a patient with placenta percreta who underwent this technique. She developed bilateral pseudoaneurysms, unilateral arterial rupture and compromised vascular supply to her right leg secondary to thrombus formation, and suffered massive haemorrhage, both despite and as a result of intervention. This is the first case report of multiple complications in an obstetric patient after temporary internal iliac balloon occlusion in an elective setting.
authors.affiliation: Department of Anaesthesia, St. Mary's Hospital, Central Manchester University Hospitals, NHS Foundation Trust, Manchester, UK.
authors.forename: S
authors.initials: S
authors.lastname: Bishop
authors.forename: K
authors.initials: K
authors.lastname: Butler
authors.forename: S
authors.initials: S
authors.lastname: Monaghan
authors.forename: K
authors.initials: K
authors.lastname: Chan
authors.forename: G
authors.initials: G
authors.lastname: Murphy
authors.forename: L
authors.initials: L
authors.lastname: Edozien
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D017541:Aneurysm, False / Q000150:complications; D000792:Angiography; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002404:Catheterization / Q000009:adverse effects*; D002585:Cesarean Section; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D005263:Femoral Artery; D006801:Humans; D007083:Iliac Artery; D010921:Placenta Accreta / Q000628:therapy*; D011247:Pregnancy