Cesarean Hysterectomy for Abnormal Placentation Using Balloon Occlusion of the Common Iliac Artery: Case Series

Abstract

Objective: To investigate the management and safety of cesarean hysterectomy using common 
iliac artery balloon occlusion (CIABO) for placenta percreta/increta/accreta.
 Patients and Methods: We performed 4 cesarean hysterectomies at 33-36 weeks of gestation. 
All 4 patients had undergone cesarean section previously and had placenta previa. The patients 
then underwent cesarean hysterectomy using CIABO.
 Results: Two patients were ultimately diagnosed with placenta percreta, one with placenta in
creta and 1 with placenta accreta. The actual invasive depth of the placenta tended to be deeper 
than had been diagnosed before surgery. The volume of blood loss in the 3 patients whose 
balloons were placed in the common iliac artery from the start ranged from 1361-3851 ml (in
cluding amniotic fluid and fewer amounts of bleeding than these), and these patients received 
only autologous blood transfusion. All 4 patients were ultimately discharged from the hospital 
without any complications.
 Conclusion: We were able to control the blood loss well using CIABO during cesarean hyster
ectomy. We confirm that our method of managing cesarean hysterectomy for abnormal placen
tation can be conducted safely.