title: Preoperative intravascular balloon catheters and surgical outcomes in pregnancies complicated by placenta accreta: a management paradox.
abstract: OBJECTIVE
  The objective of the study was to compare outcomes between patients who did and did not receive preoperative uterine artery balloon catheters in the setting placenta accreta.
  
  
  METHODS
  This was a retrospective case-control study of patients with placenta accreta from 1990 to 2011.
  
  
  RESULTS
  Records from 117 patients with pathology-proven accreta were reviewed. Fifty-nine patients (50.4%) had uterine artery balloons (UABs) placed preoperatively. The mean estimated blood loss (EBL) was lower (2165 mL vs 2837 mL; P = .02) for the group that had UABs compared with the group that did not. There were more cases with an EBL greater than 2500 mL and massive transfusions of packed red blood cells (>6 units) in the group that did not have UABs. Percreta was diagnosed more often on final pathology in the group with UABs. Surgical times did not differ between the 2 groups. Two patients (3.3%) had complications related to the UABs.
  
  
  CONCLUSIONS
  Preoperative placement of UABs is relatively safe and is associated with a reduced EBL and fewer massive transfusions compared with a group without UABs.
authors: Division of Maternal-Fetal Medicine, Department of Reproductive Medicine, University of California, San Diego, Health System, San Diego, CA.
authors: Jerasimos
authors: J
authors: Ballas
authors: Andrew D
authors: AD
authors: Hull
authors: Cheryl
authors: C
authors: Saenz
authors: Carri R
authors: CR
authors: Warshak
authors: Anne C
authors: AC
authors: Roberts
authors: Robert R
authors: RR
authors: Resnik
authors: Thomas R
authors: TR
authors: Moore
authors: Gladys A
authors: GA
authors: Ramos
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D010921:Placenta Accreta / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome; D058738:Uterine Balloon Tamponade