The application of temporary balloon occlusion of the internal iliac artery in performing cesarean hysterectomy for patients with pernicious placenta previa: An initial experience in five cases

Objective: To explore the clinical application of temporary balloon occlusion of the internal iliac artery in performing cesarean hysterectomy for patients with pernicious placenta previa. Methods: Five cases with ultrasound and MRI-proved pernicious placenta previa were enrolled in this study. Before cesarean hysterectomy, temporary balloon implantation in internal iliac artery was carried out in all five patients. The balloon was inflated by using a syringe immediately after the removal of the fetus and clamping of the umbilical cord were accomplished. The balloon was removed at 24 hours after the cesarean section. The radiation dose and the amount of blood loss during the procedure were recorded. Close inspection of the occurrence of complications was executed. The results were analyzed. Results: Technical success, including correct placement of balloon, was obtained in all five patients. The blood loss < 500 ml was seen in three patients and > 1 000 ml in 2 patients. The uterus was retained in 3 cases. Massive intractable hemorrhage during cesarean section occurred in 2 cases, and total hysterectomy (n = 1) or partial hysterectomy (n = 1) had to be carried out. Conclusion: The results of this study indicate that temporary balloon occlusion of the internal iliac artery in performing cesarean hysterectomy is a safe and effective technique, it can reduce the amount of blood loss during the procedure as well as the risk of hysterectomy.