Temporary Balloon Occlusion of the Internal Iliac Arteries to Prevent Massive Hemorrhage during Cesarean Delivery in a Patient with Placenta Previa Increta - Case Report

Abstract

In recent years, the number of cesarean deliveries has been constantly increasing, leading to higher incidence of complications due to abnormal placental location or attachment in the following pregnancies (1), with an obstetric hemorrhage in the postpartum period being the most severe of them. Placenta increta is a serious obstetrical complication caused by a defect in the decidua basalis resulting in an abnormally invasive placental implantation. Several studies have shown that conservative management by leaving placenta in situ was successful in many cases with invasive placental implantation (2). But there were still a number of failed cases with delayed hysterectomy and severe maternal morbidity. Placenta accreta and previa are the two forms of placental maldevelopment, which constitute the major cause of severe peripartum bleeding the most frequent cause of maternal mortality with an incidence rate reported as high as 30% (3-5). These two conditions still pose a challange in the obstetric practice (6). Case below is an interesting and informative on the basis of which we present diagnostic methods and a safe, minimally invasive way of delivery which is at risk of massive hemorrhage.