title: Balloon occlusion of the internal iliac arteries in the multidisciplinary management of placenta percreta.
abstract: OBJECTIVE
  To evaluate our experience with prophylactic balloon occlusion of the internal iliac arteries as a part of a multidisciplinary algorithm for the management of placenta percreta.
  
  
  METHODS
  Consecutive case series. Setting. Rigshospitalet, Copenhagen University Hospital, Denmark. Sample. Seventeen women with placenta percreta.
  
  
  METHODS
  Demographic characteristics, intraoperative data and outcomes are summarized and discussed.
  
  
  METHODS
  Feasibility of local resection, intraoperative blood loss and transfusion requirements.
  
  
  RESULTS
  The multidisciplinary management allowed for local resections in nine of the 11 women who requested preservation of fertility. The mean intraoperative blood loss was 4050 mL (range 450-16 000 mL, median 2500 mL). Adhesions to the bladder or the parietal peritoneum were associated with an intraoperative blood loss >6000 mL.
  
  
  CONCLUSIONS
  Prophylactic balloon occlusion of the internal iliac arteries as part of a multidisciplinary algorithm allowed for a safe management of all cases in our consecutive series of 17 women with placenta percreta. However, intraoperative blood loss and transfusion requirements were significant. We have therefore decided to modify our multidisciplinary algorithm to include balloon occlusion of the common iliac arteries rather than the internal iliac arteries.
authors.affiliation: Department of Cardiovascular Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. clausen.caroline@gmail.com
authors.forename: Caroline
authors.initials: C
authors.lastname: Clausen
authors.forename: Jakob
authors.initials: J
authors.lastname: Stensballe
authors.forename: Charlotte K
authors.initials: CK
authors.lastname: Albrechtsen
authors.forename: Marc A
authors.initials: MA
authors.lastname: Hansen
authors.forename: Lars
authors.initials: L
authors.lastname: Lönn
authors.forename: Jens
authors.initials: J
authors.lastname: Langhoff-Roos
mesh_terms: D000328:Adult; D021721:Balloon Occlusion / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002585:Cesarean Section / Q000379:methods; D003718:Denmark / Q000453:epidemiology; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D007083:Iliac Artery; D033183:Interdisciplinary Communication; D010921:Placenta Accreta / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology